Abstract W P171: Findings of Magnetic Resonance Imaging and Carotid Duplex as Predictors of Recurrent Brain Infarction -Bingo Cerebral Infarction Study 1-

Abstract

Introduction: To retrospectively evaluate whether findings of magnetic resonance imaging (MRI) and carotid duplex are predictors of recurrent cerebral infarction. Methods: Between 2007 and 2010, 1324 patients underwent carotid duplex, magnetic resonance angiography, fluid-attenuated inversion recovery imaging, and T2*-weighted imaging during first admission for cerebral infarction and were discharged with a modified Rankin Scale (mRS) score of 0-3. Of the 1324 patients, 1138 (86.0%) were followed up (median age, 70 years; male:female ratio, 64%:36%). Atherothrombotic infarction, lacunar infarction, cardiogenic embolism, and other infarctions occurred in 435, 430, 246, and 27 patients, respectively. Results: The median follow-up duration was 44.5 months; 84.4% patients underwent follow-up MRI. New ischemic brain events occurred in 213 patients (18.7%). Transient ischemic attack occurred as the first new ischemic brain event in 44 patients. New asymptomatic cerebral infarction appeared in 100 patients before or without new ischemic brain events. Symptomatic cerebral infarction (SCI) recurred in 172 cases (15.1%), and the median duration between discharge and recurrence was 18.6 months (range, 0.2-69.5 months). Atherothrombotic infarction, lacunar infarction, and cardiogenic embolism recurred in 64, 64, and 42 patients, respectively. At the last follow-up, mRS score was 0-3 in 1029 patients and 27 patients died. Intracranial artery stenosis and micro-bleeding were significant predictors of SCI after lacunar infarction. Pre-admission asymptomatic old cerebral infarction was a significant predictor of SCI after 3 subtypes. Internal carotid artery stenosis >50% on carotid duplex was a significant predictor of SCI after atherothrombotic infarction. Conclusion: Findings of MRI and carotid duplex may be important predictors of recurrent cerebral infarction.