Risk of Silent Cerebral Infarctions Doubled in Atrial Fibrillation房颤患者隐性脑梗的风险增加一倍以上

A systematic review and meta-analysis revealed that atrial fibrillation (AF) is associated with more than a 2-fold increase in the odds for silent cerebral infarctions (SCI). CT and MRI studies were combined in 4,407 patients (505 with AF and 3,902 without), 230 AF patients (45.54%) and 610 patients without AF (15.63%) had SCIs. The overall prevalence of SCI lesions on MRI and CT among patients with AF was 40% and 22%, respectively. AF was associated with SCIs in patients with no history of symptomatic stroke independent of AF type (paroxysmal vs. persistent). AF patients have a four- to five-fold increased risk for clinically evident stroke, and they are also at risk for larger brain infarctions and worse outcomes following stroke, compared with the general population. AF may be associated with a 40% increase in the risk for cognitive impairment, SCI may be one of the mechanisms. The benefit of anticoagulant therapy for the prevention of symptomatic stroke in AF patients is well documented, but not for SCI. Source: http://annals.org/一项系统综述和荟萃分析显示房颤可增加隐性脑梗风险一倍以上。对4407例（其中房颤505例）患者的CT和MRI研究进行综合分析，房颤者230例（45.54％）和无房颤者610例（15.63％）有隐性脑梗。经MRI和CT检查，房颤患者隐性脑梗的总患病率分别为40％和22％。无论是阵发性或持续性房颤，均与无显性中风史患者的隐性脑梗有关。房颤患者显性中风的风险增加4至5倍。而且与普通人群相比他们有发生较大脑梗的风险，中风后预后较差。 房颤可使认知功能障碍的风险增加40%，隐性脑梗可能是机制之一。抗凝治疗对房颤患者可预防显性中风有据可查，而非隐性脑梗。来源：http://annals.org/