LAUSR

Introduction: Myocardial infarction (MI) is associated with cerebral infarction. We assessed whether MI size and location is related to the risk of cerebral infarction. Methods: We performed a cross-sectional study of patients evaluated between 2014-2017 at New York-Presbyterian Hospital/Weill Cornell Medicine. We included all adults who underwent both brain MRI and delayed-enhancement cardiac MRI (DE-CMR) within 365 days of each other and had evidence of MI on DE-CMR. We evaluated associations between MI size and any cerebral infarction, apical MI and any cerebral infarction, and between MI size/location and cortical versus subcortical cerebral infarction. We used multiple logistic regression models adjusted for age, sex, race, and the total number of vascular risk factors. Results: We identified 234 patients who underwent DE-CMR and brain MRI within 365 days, among whom 76 had evidence of MI on DE-CMR. Of these 76 patients, 51 (67.1%) had evidence of cerebral infarction. There was no association between the size of MI (global MI burden) and any cerebral infarction (OR per 1% increase in MI size, 1.02; 95% CI, 1.0-1.1; P = 0.43), but there was an association between MI size and cortical cerebral infarction (OR per 1% increase in MI size, 1.05; 95% CI, 1.0-1.1; P = 0.047). We found no association between apical MI location and any cerebral infarction (OR 3.2, 95% CI, 0.9-12.2, P = 0.08), but there was an association between apical MI location and cortical cerebral infarction (OR, 3.7; 95% CI, 1.2-11.3; P = 0.02). Conclusion: Among patients with MI on cardiac imaging, MI size and apical MI location were associated with cortical cerebral infarction. Our results may help stratify cardioembolic risk and lead to improved antithrombotic treatment algorithms among patients with MI.