Related Experiment Video
Updated: Nov 2, 2025
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Microbleeds and clinical outcome in acute mild stroke patients treated with antiplatelet therapy: ADS post-hoc
Junya Aoki1, Yasuyuki Iguchi2, Takao Urabe3
1Department of Neurology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan; Department of Stroke Medicine, Kawasaki Medical School, Kurashiki, Japan.
Background And Purpose:
In this post-hoc analysis using acute dual study dataset, the impacts of cerebral microbleeds (MBs) after mild stroke on clinical outcome were investigated.
Methods:
The number of MBs on admission was categorized as 1) no MBs, 2) MBs 1-4, 3) MBs 5-9, and 4) MBs ≥ 10. The efficacy outcome was defined as neurological deterioration and stroke recurrence within 14 days. Safety outcomes included ICH and/or SAH as well as extracranial hemorrhages.
Results:
Of the 1102 patients, 780 (71%) had no MBs on admission, while 230 (21%) had MBs 1-4, 48 (4%) had MBs 5-9, and 44 (4%) had MBs ≥ 10. The number of MBs was not associated with the neurological deterioration and/or stroke recurrence (p = 0.934), ICH and/or SAH (p = 0.743), and extracranial hemorrhage (p = 0.205). Favorable outcome was seem in 84% in the No MBs group, 83% in the MBs 1-4, 94% in the MBs 5-9, and 85% in the MBs ≥ 10 (p = 0.304). Combined cilostazol and aspirin therapy did not alter any rates of efficacy and safety outcomes among the no MBs, MBs 1-4, MBs 5-9, and MBs ≥ 10 groups compared to aspirin alone (all p > 0.05). By multivariate regression analysis, a history of ICH and diastolic blood pressure were the independent parameters to all of the MBs criteria (presence, MBs ≥ 5, and MBs ≥ 10).
Conclusions:
MBs did not alter the clinical outcome at 3 months of onset. Elevated diastolic blood pressure and a history of ICH were the essential parameters related to the MBs.
Insights
Cerebral microbleeds (MBs) after mild stroke did not impact clinical outcomes or stroke recurrence. However, a history of intracranial hemorrhage (ICH) and high diastolic blood pressure were linked to MBs presence.
Area of Science:
- Neurology
- Stroke Medicine
- Neuroimaging
Background:
- Cerebral microbleeds (MBs) are small hemorrhages in the brain.
- Their impact on clinical outcomes after mild stroke requires further investigation.
Purpose of the Study:
- To analyze the effect of cerebral microbleeds (MBs) on clinical outcomes in patients with mild stroke.
- To determine if MBs influence neurological deterioration, stroke recurrence, or hemorrhage risk.
Main Methods:
- A post-hoc analysis of the acute dual study dataset was performed.
- Patients were categorized by the number of MBs on admission (0, 1-4, 5-9, ≥10).
- Efficacy outcomes included neurological deterioration and stroke recurrence within 14 days; safety outcomes included intracranial hemorrhage (ICH)/subarachnoid hemorrhage (SAH) and extracranial hemorrhages.
Main Results:
- Out of 1102 patients, 71% had no MBs, while 29% had varying degrees of MBs.
- The number of MBs was not significantly associated with neurological deterioration, stroke recurrence, ICH/SAH, or extracranial hemorrhages.
- Favorable outcomes were observed in 84% (no MBs) to 94% (MBs 5-9) of patients.
- Combined cilostazol and aspirin therapy did not alter efficacy or safety outcomes compared to aspirin alone.
- A history of ICH and elevated diastolic blood pressure were independent predictors for MBs presence and severity.
Conclusions:
- Cerebral microbleeds (MBs) did not significantly alter clinical outcomes at 3 months post-mild stroke.
- Elevated diastolic blood pressure and a prior history of intracranial hemorrhage (ICH) are key factors associated with the presence of MBs.
Related Concept Videos
01:22Formation of the Platelet Plug
As the injured blood vessel contracts, endothelial cells undergo contraction, revealing collagen fibers in the basement membrane and underlying connective tissue. Furthermore, the plasma membrane of endothelial cells becomes adhesive, preparing the site for platelet adhesion. Platelets...
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...