Silent brain infarction in the presence of systemic vascular disease

OBJECTIVE: To determine the prevalence of asymptomatic brain ischaemic in the presence of vascular disease in other arterial territories. DESIGN: Studies up to January 2011 were identified through comprehensive search strategies. Arcsine transformation for meta-analysis was used to calculate the standardized mean difference (SMD) and 95% confidence intervals (CI). SETTING: A systematic review and meta-analysis were performed. PARTICIPANTS: For each study, the proportion of patients positive for SBI in the presence of other systemic vascular disease was extracted and analyzed. MAIN OUTCOME MEASURES: Using a random-effects model, a pooled effect estimate interpreted as a percentage prevalence of disease was calculated. RESULTS: SBI in the presence of acute ischaemic stroke was found in 23% (SMD 0.99; P < 0.001; 95% CI 0.88–1.10); a 35% prevalence was found in patients with coronary artery disease (SMD 1.26; P < 0.001; 95% CI 0.95–1.58); and a 14% prevalence in patients with peripheral artery disease (SMD 0.48; P < 0.002; 95% CI 0.42–0.54), although the data-set in the latter is smaller. CONCLUSIONS: Patients with systemic vascular disease are at an increased risk of silent brain infarction.