2018•StrokeRequires access
Abstract TP191: Association Between Myocardial Infarction and Brain Infarction on Magnetic Resonance Imaging
Alexander E. Merkler, Hediyeh Baradaran, Pavan K Myeni, Gino Gialdini, Babak B. Navi, Parag Goyal, Monika M. Safford, Peter M. Okin, Jonathan W. Weinsaft, Ajay Gupta, Hooman Kamel
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Abstract
Introduction: The relationship between myocardial infarction and brain infarction remains incompletely understood. Magnetic resonance imaging (MRI) offers excellent characterization of infarction in both the heart and brain. Methods: We performed a retrospective cross-sectional study at our hospital to evaluate the association between myocardial infarction and brain infarction as detected on MRI. We identified all adult patients who underwent both cardiac MRI and brain MRI within 6 months of each other during the period 2014-2017. Myocardial infarction was identified by the presence of myocardial scar on delayed enhancement cardiac MRI. A neuroradiologist investigator reviewed all brain MRI studies to characterize acute and chronic infarcts. In secondary analyses, we evaluated the association between myocardial infarction and cortical versus subcortical brain infarction. The chi-square test was use to compare categorical variables. Results: We identified 211 adults who underwent cardiac MRI and brain MRI within 6 months of each other. Myocardial infarction was present in 66 (31.3%) of cardiac MRIs. Brain infarction was present in 112 (53.1%) of brain MRIs, 61 (28.9%) of which were cortical infarcts, 33 (15.6%) subcortical, and 18 (8.5%) posterior fossa. Myocardial infarction was more common in patients with brain infarction (41.1%; 95% confidence interval [CI], 31.9-50.8%) than in patients without brain infarction (20.2%; 95% CI, 12.8-29.5%) ( P = 0.001). In secondary analyses, myocardial infarction was most common in patients with cortical brain infarcts (50.8%; 95% CI, 37.7-63.9%), less common in patients with only subcortical infarcts (27.3%; 95% CI, 13.3-45.5%), and least common in those with no brain infarcts ( P value for comparison among groups, < 0.001). Conclusions: We found an association between myocardial infarction and brain infarction on MRI. The association was strongest between myocardial infarcts and cortical brain infarcts.