title: Aspirin attenuates the incidence of silent brain lesions in patients with nonvalvular atrial fibrillation.
abstract: BACKGROUND
  Abnormal findings, including silent cerebral infarction, are frequently observed by magnetic resonance imaging (MRI) in patients with nonvalvular atrial fibrillation (NVAF); however, the prevalence and prevention strategy for these lesions have not been extensively studied. In the present study the preventive effects of aspirin on silent ischemic lesions was investigated.
  
  
  RESULTS
  Silent lesions were counted using cranial MRI performed in 78 neurologically normal adults with sinus rhythm and in 212 patients with NVAF without a history of stroke. MRIs were repeated twice in the NVAF patients at 12-month intervals. During the first year, patients received neither antiplatelet agent nor anticoagulant; in the second year, aspirin (330 mg daily) was administered. The prevalence of lesions in the initial MRI was higher in NVAF patients (86.4%) than in sinus rhythm subjects (53.8%; p<0.001). After 12 months without aspirin, new lesions were seen in 20.6% of NVAF patients. The yearly occurrence of new lesions was decreased to 9.6% during the year of treatment with aspirin (p=0.014).
  
  
  CONCLUSIONS
  In patients with NVAF, abnormal lesions are frequently observed by MRI and aspirin treatment may be effective in preventing further small silent lesions.
authors.affiliation: Division of Cardiology and Strokology, Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine, Suita, Japan. satoz@medone.med.osaka-u.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sato
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Koretsune
authors.forename: Masatake
authors.initials: M
authors.lastname: Fukunami
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Kodama
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Yamada
authors.forename: Kenshi
authors.initials: K
authors.lastname: Fujii
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kitagawa
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Hori
mesh_terms: D000368:Aged; D001241:Aspirin / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D001921:Brain / Q000473:pathology; D002545:Brain Ischemia / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D015995:Prevalence; D012307:Risk Factors; D020521:Stroke / Q000209:etiology
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin