Silent cerebral infarcts in patients with atrial fibrillation: Clinical implications of an imaging-adjusted CHA2DS2-VASc score

Background: The CHA2DS2-VASc score does not include silent infarcts on neuroimaging in stroke risk estimation for patients with atrial fibrillation (AF). The inclusion of silent infarcts into CHA2DS2-VASc scoring and its impact on stroke prophylaxis recommendations in patients with AF has not been previously studied. The present study sought to quantify the prevalence of silent infarcts in patients with AF and describe potential changes in management based on magnetic resonance imaging (MRI) findings. Methods: Participants from the Mayo Clinic Study of Aging with AF and brain MRI were included. Silent infarcts were identified. “Standard” CHA2DS2-VASc scores were calculated for each subject based on clinical history alone and “imaging-adjusted” CHA2DS2-VASc scores based on evidence of cerebral infarction on MRI. Standard and imaging-adjusted scores were compared. Results: 147 participants (average age 77, 28% female) were identified with AF, MRI, and no clinical history of stroke. Overall, 41 (28%) patients had silent infarcts on MRI, corresponding with a 2-point increase in CHA2DS2-VASc score. Of these participants, only 39% (16/41) with silent infarct were on anticoagulation despite that standard CHA2DS2-VASc scores supportive of anticoagulation. After incorporating silent infarcts, 13% (19/147) would have an indication for periprocedural bridging compared to 0.6% (1/147) at baseline. Conclusions: Incorporation of silent infarcts into the CHA2DS2-VASc score may change the risk-benefit ratio of anticoagulation. It may also increase the number of patients who would benefit from periprocedural bridging. Future research should examine whether an anticoagulation strategy based on imaging-adjusted CHA2DS2-VASc scores could result in a greater reduction of stroke and cognitive decline

U.M.W.A. Colored Delegation on the Monument Steps, 1927

The United Mine Workers of America (UMWA) became the official representative of coal miners across the country in 1890. Eight years later, the union selected Indianapolis as the location for its national headquarters and held its annual conventions in the city every year until 1934. In this 1927 image, the United Mine Workers Colored Delegation posed on the steps of the Monument with the northern quadrants in the background.Appears in Destination Indiana 1, 2 Appears in Big Screen Journey Welcome to Monument Circl

[Photograph 2012.201.B0227.0485]

Photograph taken for a story in the Oklahoma Times newspaper

Little Girl's Dresses on Display in Block's Department Store, 1951

Little girl's dresses on display in Block's Department Store in 1951

[Photograph 2012.201.B0224.0675]

Photograph taken for a story in the Daily Oklahoman newspaper. Caption: "A national American Legion official said in Oklahoma City Thursday he believes most of the trouble in this country's conflict by indecisiveness at the national level. Dr. Arthur Chopin said indecision on the part of the U.S. State department led to the present situation in Cuba.

General Executive Board, United Brotherhood of Carpenters and Joiners of America, 1947-1955

For complete collection information, visit the full finding aid at http://hdl.handle.net/1903.1/1393 Image 1 - A composite image composed of twelve portrait photographs of the members of the General Executive Board of the United Brotherhood of Carpenters and Joiners of America for 1947-1948. Top row, from left: Frank Duffy, General Secretary; M. A. Hutcheson, First General Vice President; William L. Hutcheson, General President; John R. Stevenson, Second General Vice President; S. P. Meadows, General Treasurer. Bottom row, from left: Charles Johnson, Jr., First District; William J. Kelly, Second District; Harry Schwarzer, Third District; Roland Adams, Fourth District; R. E. Roberts, Fifth District; A. W. Muir, Sixth District; Arthur Martel, Seventh District. Image 2 - A composite image composed of thirteen portrait photographs of the members of the General Executive Board of the United Brotherhood of Carpenters and Joiners of America for 1948-1951. Top row, from left: Albert E. Fischer, Acting General Secretary; Frank Duffy, General Secretary Emeritus; M. A. Hutcheson, First General Vice President; William L. Hutcheson, General President; John R. Stevenson, Second General Vice President; S. P. Meadows, General Treasurer. Bottom row, from left: Charles Johnson, Jr., First District; O. William Blaier, Second District; Harry Schwarzer, Third District; Roland Adams, Fourth District; R. E. Roberts, Fifth District; A. W. Muir, Sixth District; Arthur Martel, Seventh District. Image 3 - A composite image composed of thirteen portrait photographs of the members of the General Executive Board of the United Brotherhood of Carpenters and Joiners of America for 1951-1955. Top row, from left: Frank Duffy, General Secretary Emeritus; Albert E. Fischer, General Secretary; M. A. Hutcheson, First General Vice President; William L. Hutcheson, General President; John R. Stevenson, Second General Vice President; S. P. Meadows, General Treasurer. Bottom row, from left: Charles Johnson, Jr., First District; O. William Blaier, Second District; Harry Schwarzer, Third District; Roland Adams, Fourth District; R. E. Roberts, Fifth District; A. W. Muir, Sixth District; A. Cooper, Seventh District. Photograph by Noble Bretzman. Image 4 - Group portrait photograph of the general executive board of the United Brotherhood of Carpenters and Joiners of America, inside the Indianapolis, Indiana headquarters, November 1955. The executive board is seated around a large table, each labeled. Painted on the top is a banner that reads "At the helm of the United Brotherhood of Carpenters and Joiners of America". Behind the table a carved bust of Wm. L. Hutcheson looms. The officers around the table are, beginning with the head of the table under the bust and going clockwise: M.A. Hutcheson, General President; Frank Chapman, General Treasurer; O. Wm. [William] Blaier, Second General Vice President; Andrew V. Cooper, Exec. [Executive] Bd. [Board] Member, Seventh District; F. F. Cambiano, Gen. Exec. Bd. Member, Sixth District; R. E. Roberts, Gen. Exec. Bd. Member, Fifth District; John R. Stevenson, First General Vice-President; Henry W. Chandler, Gen. Exec. Bd. Member, Fourth District; Harry Schwarzer, Gen. Exec. Bd. Member, Third District; Raleigh Rajoppi, Gen. Exec. Bd. Member, Second District; Charles Johnson, Jr., Gen. Exec. Bd. Member, First District; Albert E. Fischer, General Secretary. Image 5 - Group portrait photograph of the general executive board of the United Brotherhood of Carpenters and Joiners of America, inside the Indianapolis, Indiana headquarters, probably November 1955. The executive board is seated around a large table. Behind the table a carved bust of Wm. L. Hutcheson looms. The officers around the table are, beginning with the head of the table under the bust and going clockwise: M.A. Hutcheson; Frank Chapman; O. Wm. [William] Blaier; Andrew V. Cooper; F. F. Cambiano; R. E. Roberts; John R. Stevenson; Henry W. Chandler; Harry Schwarzer; Raleigh Rajoppi; Charles Johnson, Jr.; Albert E. Fischer. Image 6 - Back of photo of general executive board at table. Handwritten is "Board Room - General Office - Indianapolis, Ind. [Indiana] 1950's"

Christmas Cakes Displayed at L.S. Ayres Department Store, 1937

The chair, wreaths, bear, and presents under the tree are cakes made in the L.S. Ayres Bakery by Vern C. Vanderbilt. They are displayed in a showcase in the store

Santa Claus and His Sleigh at L.S. Ayres Department Store, 1945

Santa Claus is seated in a sleigh. There are artificial trees and reindeer in the display. A mailbox for messages to Santa is located at the entrance ramp leading to the sleigh

Block's Store Window Display of Men's Clothing, 1951

A view of the Block's store windows with men's suits, coats, and hats on display in 1951

Rockwood Family Portrait

According to the customer card Charles Bretzman took some family portraits at the home of William M. Rockwood in 1929. William was married to Virginia and they had two sons, William M. and John A., and a daughter Josephine. This may be Virginia and Josephine standing in front of their home at 3641 Washington Boulevard in Indianapolis. William Rockwood was the secretary-treasurer of the Rockwood Manufacturing Company at the time.This image is a preservation copy made from an unstable original nitrate negative. The image is part of Series III