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Aspirin treatment increases the risk of cerebral microbleeds

Lihong Ge1, Guangming Niu, Xiaodong Han

  • 1Department of Imaging, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing, China.

The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques
|October 28, 2011
PubMed
Abstract

Insights

Long-term aspirin use in Chinese patients with a history of stroke or TIA significantly increases the risk of cerebral microbleeds (CMBs) and intracerebral hemorrhage (ICH). This highlights the importance of monitoring for these complications in patients on long-term aspirin therapy.

Area of Science:

  • Neurology
  • Radiology
  • Pharmacology

Background:

  • Cerebral microbleeds (CMBs) are small hemorrhages in the brain, often associated with cerebrovascular disease.
  • Aspirin is commonly prescribed for patients with a history of transient ischemic attack (TIA) or stroke to prevent further events.
  • Phase-sensitive imaging offers advanced detection capabilities for CMBs.

Purpose of the Study:

  • To investigate the frequency of cerebral microbleeds (CMBs) in patients with a history of TIA or stroke undergoing aspirin treatment.
  • To compare CMB prevalence between patients on long-term aspirin and controls not receiving aspirin.
  • To identify risk factors associated with CMBs in these patient groups.

Main Methods:

  • Retrospective analysis of 300 outpatients with ischemic cerebrovascular disease.
  • Two groups were studied: 150 patients on aspirin for >1 year and 150 controls without prior aspirin use.
  • Cerebral microbleeds were identified using phase-sensitive magnetic resonance imaging (MRI) and other MRI sequences by a blinded observer. Vascular risk factors were also assessed.

Main Results:

  • The frequency of CMBs was significantly higher in aspirin-treated patients (40%) compared to controls (12%).
  • Intracerebral hemorrhage (ICH) was also significantly more frequent in the aspirin group (28% vs 1%).
  • Long-term aspirin use (>5 years) was associated with a substantially higher CMB frequency (62% vs 22%). White matter hyperintensity, age, and hypertension were also linked to CMBs.

Conclusions:

  • Aspirin treatment, particularly long-term use, significantly increases the occurrence of CMBs and associated intracerebral hemorrhage in Chinese patients with a history of ischemic cerebrovascular events.
  • The findings underscore the impact of aspirin on hemorrhagic complications in this patient population.
  • Phase-sensitive imaging is a valuable tool for detecting CMBs.

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