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Clopidogrel use is associated with an increased prevalence of cerebral microbleeds in a stroke-free population: the

Sirwan K L Darweesh1, Maarten J G Leening, Saloua Akoudad

  • 1Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands.

Journal of the American Heart Association
|September 28, 2013
PubMed
Abstract

Insights

Clopidogrel use in stroke-free individuals was linked to more cerebral microbleeds (CMBs). This association suggests a potential risk, though further research is needed to confirm causality.

Area of Science:

  • Neurology
  • Cardiology
  • Radiology

Background:

  • Clopidogrel use is associated with increased bleeding risk.
  • Cerebral microbleeds (CMBs) indicate subclinical brain microangiopathy and may precede hemorrhage.
  • The relationship between clopidogrel and CMBs in stroke-free individuals was unexplored.

Purpose of the Study:

  • To investigate the association between clopidogrel use and the presence of cerebral microbleeds (CMBs).
  • To assess if clopidogrel use correlates with a higher prevalence or number of CMBs in individuals without a prior stroke.

Main Methods:

  • Cross-sectional analysis of the prospective, population-based Rotterdam Study.
  • Included 4408 stroke-free individuals aged 45+ who underwent brain MRI for CMB detection.
  • Used logistic regression, adjusting for demographics, cardiovascular risk factors, and medications.

Main Results:

  • Clopidogrel users (n=121) showed a higher prevalence of CMBs (OR 1.55) compared to non-users (n=4287).
  • Users were more likely to have a high number of CMBs (>4) (OR 3.19).
  • Clopidogrel use was linked to increased prevalence of deep or infratentorial CMBs (OR 1.90).

Conclusions:

  • Clopidogrel use is associated with a higher prevalence and number of CMBs in stroke-free individuals.
  • The causal nature of this association requires confirmation in prospective studies.
  • Small sample size of clopidogrel users and potential residual confounding warrant caution.
Keywords:
cerebral microbleedmagnetic resonance imagingplatelet inhibitorpopulation studies

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