Cerebral Microbleeds: Relationship to Antithrombotic Medications

Area of Science:

• Neurology
• Radiology
• Cardiology

Background:

• Cerebral microbleeds (CMBs) are small hemosiderin deposits visible on brain MRI.
• CMBs affect approximately 23% of cognitively normal individuals over 60.
• CMBs are associated with increased risk of stroke and cardiovascular mortality.

Purpose of the Study:

• To investigate the correlation between antithrombotic medications and the presence of CMBs in a population-based study.
• To determine if the association between antithrombotics and CMBs is direct or mediated by other factors.

Main Methods:

• Analysis of 1253 participants from the Mayo Clinic Study of Aging using T2* gradient-recalled echo MRI.
• Multivariable and ordinal logistic regression models to assess the relationship between antithrombotic use and CMB presence/frequency.
• Structural equation modeling to evaluate the influence of antithrombotics, age, sex, vascular risk factors, and amyloid load on CMBs.

Main Results:

• CMBs were present in 26.3% of participants.
• Anticoagulant use was significantly correlated with the presence and frequency of CMBs (45.3% prevalence).
• Antiplatelet agents showed no significant correlation with CMBs; however, combined therapy had a 48.8% prevalence.

Conclusions:

• Anticoagulant use is directly associated with the presence of cerebral microbleeds in the general population.
• Amyloid positron emission tomography (PET) findings correlate with the count of CMBs in individuals with CMBs.