Mediterranean Diet and its Effects on Silent Brain Infarcts in a Cohort of Patients With Atrial Fibrillation

[Background and Aims] The benefits of Mediterranean Diet (MeDiet) in prevention of cardiovascular diseases (CVD) in general and ischemic stroke (IS) have been extensively studied and reported. We hypothesize that the consumption of nutrients typical of MeDiet would also reduce the rate of silent brain infarcts (SBI) among AF patients.[Methods and Results] Patients with a history of AF who scored 0 to 1 in the CHADS2 score, ⩾50 years and with absence of neurological symptoms were selected from Seville urban area using the Andalusian electronic healthcare database. A 3T brain MRI was performed to all participants. Demographic and clinical data and food-frequency questionnaire (FFQ) were collected. Of the 443 scanned patients, 66 presented SBI. Of them 52 accepted to be scheduled for a clinical visit and were included in the diet sub study and 41 controls were matched per age and sex. There were no statistically significant differences in baseline characteristics. After logistic regression analysis, we found that a higher consumption of fiber from fruit was independently associated with a lower risk of SBI, while a higher consumption of high glycemic load (GL) foods was associated with a higher risk of SBI in a population with AF[Conclusion] Our findings support that MeDiet could be suggested as a prevention strategy for SBI in patients with AF.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The Spanish Ministry of Economy, Industry and Competitiveness (grant RTC-2016 5300-1), the Junta de Andalucía (grant PIN-0144-2016) and Neuroprotección Avanzada Reposicionando Drogas y Nutraceúticos para el Ictus en Andalucía: Proyecto NARDNIA (PE-0527-2019), the European Project ITRIBIS (registration number REGPOT-2013-1), and Cooperative Cerebrovascular Disease Research Network (INVICTUS+, RD16/0019/0015) supported the study. The Fundación Cajasol also contributed to the study.Peer reviewe

Prevalence and risk factors of silent brain infarcts in patients with AF detected by 3T-MRI

[Background] Silent brain infarcts (SBI), a finding on neuroimaging, are associated with higher risk of future stroke. Atrial Fibrillation (AF) has been previously identified as a cause of SBI.[Objectives] The aim of this study is to determine the prevalence of and risk factors for SBI in patients with AF and low-to-moderate embolic risk according to CHADS2 and CHA2DS2VASc score.[Methods] Patients with a history of AF based on medical records who scored 0–1 in the CHADS2 score were selected from the Seville urban area using the Andalusian electronic healthcare database (DIRAYA). Demographic and clinical data were collected and a 3T brain MRI was performed on patients older than 50 years and with absence of neurological symptoms.[Results] 66 of the initial 443 patients (14.9%) and 41 of the 349 patients with low risk according to CHA2DS2VASc score (11.7%) presented at least 1 SBI. After adjusted multivariable analysis, an older age (OR 3.84, 95% CI 1.07–13.76) and left atrial (LA) enlargement (OR 3.13, 95% CI 1.15–8.55) were associated with SBI in the whole cohort, while only LA enlargement was associated with SBI in the low-risk cohort (OR 3.19, 95% CI 1.33–7.63).[Conclusions] LA enlargement on echocardiogram was associated with SBI in patients with AF and low or moderate embolic risk according to CHADS2 and in the low-risk population according to CHA2DS2VASc. Although further studies are needed, a neuroimaging screening might be justified in these patients to guide medical therapies to improve stroke prevention.The Spanish Ministry of Economy, Industry and Competitiveness (Grant RTC-2016-5300-1), the Junta de Andalucía (Grant PIN-0144-2016) and the European Project ITRIBIS supported the study. The Fundación Cajasol also contributed to the study. Neurovascular Research Group is part of the Spanish Neurovascular Disease Research Network (INVICTUS + , RD16/0019/0015)

Mediterranean Diet and Physical Activity Protect from Silent Brain Infarcts in a Cohort of Patients with Atrial Fibrillation.

Several studies have demonstrated that Mediterranean diet (MeD) has beneficial effects in the prevention of cardiovascular disease (CVD)1,2 globally but also in stroke prevention.3,4 However, there are few data of the influence of MeD in silent brain infarcts (SBI). Physical activity is also a well-known protective factor for CVD and stroke.5 Atrial fibrillation (AF) increases the risk of overt stroke and also SBI. We hypothesize that a healthy lifestyle would reduce the rate of SBI among AF patients. The aim of this study is to determine the association of a healthy profile (the combination of a good MeD adherence plus high level of physical activity) and the prevalence of SBI in a population with AF