Incidence and predictors of silent embolic cerebral infarction following diagnostic
coronary angiography
- Author(s)
- In-Cheol Kim; Seung-Ho Hur; Nam-Hee Park; Dong-Hwan Jun; Yun-Kyeong Cho; Chang-Wook Nam; Hyungseop Kim; Seong-Wook Han; Sae-Young Choi; Yoon-Nyun Kim; Kwon-Bae Kim
- Keimyung Author(s)
- Kim, In Cheol; Hur, Seung Ho; Cho, Yun Kyeong; Nam, Chang Wook; Kim, Hyung Seop; Han, Seong Wook; Kim, Yoon Nyun; Kim, Kwon Bae; Park, Nam Hee; Choi, Sae Young
- Department
- Dept. of Internal Medicine (내과학)
Dept. of Thoracic & Cardiovascular Surgery (흉부외과학)
- Journal Title
- International Journal of Cardiology
- Issued Date
- 2011
- Volume
- 148
- Issue
- 2
- Abstract
- Background: Coronary angiography (CAG) is an invasive diagnostic procedure, which could lead to procedure
related complications. One of the well known post-procedural complications is cerebral embolic infarction
with or without symptoms. Silent embolic cerebral infarction (SECI) has clinical significance because it can
progress to a decline in cognitive function and increase the risk of dementia in the long term. The aim of this
study was to detect the incidence and predictors of SECI after diagnostic CAG using diffusion-weighted
magnetic resonance imaging (DW-MRI).
Methods: A total of 197 patients with coronary artery disease who underwent DW-MRI for evaluation of
intracranial vasculopathy before coronary artery bypass graft surgery were retrospectively enrolled in the
present study. DW-MRI was performed within 48 h after diagnostic CAG. SECI was diagnosed as presence of
focal bright high signal intensity in DW-MRI. Patients were divided into groups according to presence/
absence of SECI (+ SECI vs.− SECI, respectively). The clinical and angiographic characteristics were analyzed
and independent predictors were evaluated.
Results: Of the 197 patients, SECI occurred in 20 patients (10.2%) after diagnostic CAG. Age, female gender,
frequency of underlying atrial fibrillation, extent of coronary disease, and fluoroscopic time during diagnostic
CAG were not different between the + SECI and − SECI groups. Left ventricular ejection fraction was
significantly lower in the + SECI group than in the − SECI group (45.9±8.5% vs. 51.4±13.1%, p=0.014)
and performance rate of internal mammary artery (IMA) angiography was significantly higher in the + SECI
group compared with the − SECI group (85% vs. 37.2%, pb0.001). By multivariate analysis, performing IMA
angiography was the only predictor of SECI (OR=14.642; 95% CI=3.201 to 66.980, p=0.001).
Conclusions: The incidence of SECI after diagnostic CAG was not infrequent. Diagnostic CAG with IMA
angiography may increase the risk of SECI.
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