- Older adults who had imaging evidence of a prior myocardial infarction (MI) that was clinically unrecognized were 50% more likely to have cerebral infarction after other factors are taken into account.
Why this matters
- A sizable share of cerebral infarctions are idiopathic.
- 33.3% of cohort had brain MRI evidence of cerebral infarction.
- Cardiac MRI results:
- 23.9% had evidence of any MI,
- 7.4% had evidence of recognized MI, and
- 16.5% had evidence of unrecognized MI.
- Participants had increased adjusted odds of cerebral infarction if they had:
- Recognized MI (OR, 2.0; P=.01).
- Unrecognized MI (OR, 1.5; P=.04).
- Findings similar in sensitivity analyses adjusting for additional clinical factors and use of various medications.
- Participants also had increased adjusted odds specifically of embolic infarcts of undetermined source if they had unrecognized MI (OR, 2.0; P=.02).
- Icelandic cross-sectional cohort study of 925 community-dwelling older adults aged 67-93 years who underwent both brain MRI, late gadolinium enhancement cardiac MRI.
- Main outcome: cerebral infarction on brain MRI (regardless of associated symptoms).
- Funding: National Institutes of Health; others.
- Precise timing of MI, cerebral infarction not ascertainable.
- Unmeasured confounding.
- Too few clinically symptomatic strokes to assess associations.
- Uncertain generalizability.