Asymptomatic Atheromatous Cerebrovascular Diseases in Patients with Acute Myocardial Infarction —Evaluation by Brain Magnetic Resonance Angiography—

Abstract

To investigate the relationship between atherosclerosis in the cerebral and coronary arteries, we examined the prevalence of asymptomatic atheromatous cerebrovascular lesions in patients with acute myocardial infarction (AMI). The subjects consisted of 33 consecutive AMI patients with an-giographically proven coronary artery stenosis/ occlusion(s) who had no history of ischemic strokes, and 33 age/sex matched controls without a history of coronary heart diseases or/and cerebrovascular diseases. Asymptomatic cerebrovascular lesions were evaluated by magnetic resonance angiography (MRA) with a 3-dimensional time-of-flight method within 2 months after the AMI onset. The evaluated arteries on MRA included the carotid bifurcation and the intracranial arteries (intracranial portion of the internal carotid artery, horizontal portion of the middle cerebral artery, and the basilar artery). Asymptomatic cerebrovascular stenotic lesions (more than 25% stenosis) on MRA were found in 8 AMI patients (24.2%) at the carotid artery bifurcation and 5 (15.2%) in the intracranial arteries, compared to 1 (3.0%) and 3 (9.1%) respectively in control subjects. The lesions in the carotid bifurcation were significantly frequent in the AMI patients (p<0.05), while those in the intracranial arteries did not differ between the two groups. The AMI patients with the intracranial artery lesions were significantly older than those without such lesions (p<0.05). The data obtained indicates that the coexistence of asymptomatic atheromatous cerebrovascular diseases, especially the lesions in the carotid bifurcation, should be considered in treating patients with AMI. The older AMI patients, who may have not only extracranial lesions but also intracranial lesions, should be treated more carefully. © 1995, The Japan Geriatrics Society. All rights reserved.