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Association between antiplatelet medication and cerebral microbleeds in stroke-free population
Miao-Xin Yu1, Ya-Nan Jia2, Dan-Dan Yang3
1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Background:
Cerebral microbleeds (CMBs) may increase the risk of future intracerebral hemorrhage and ischemic stroke. However, It is unclear whether antiplatelet medication is associated with CMBs. This study aimed to investigate the association between antiplatelet medication and CMBs in a community-based stroke-free population.
Methods:
In this cross-sectional study, stroke-free participants aged 18-85 years were recruited from a community in Beijing, China. Demographic, clinical, and antiplatelet medication data were collected through a questionnaire, and all participants underwent blood tests and brain magnetic resonance imaging at 3.0T. The presence, count, and location of CMBs were evaluated using susceptibility-weighted imaging. The association between antiplatelet medication and the presence of CMBs was analyzed using multivariable logistic regression. The associations between antiplatelet medication and CMBs by location (lobar, deep brain or infratentorial, and mixed regions) were also analyzed using multinomial logistic regression. A linear regression analysis was conducted to determine the association between antiplatelet medication and the log-transformed number of CMBs.
Results:
Of the 544 participants (mean age: 58.65 ± 13.66 years, 217 males), 119 participants (21.88%) had CMBs, and 64 participants (11.76%) used antiplatelet medication. Antiplatelet medication was found to be associated with CMBs at any location [odds ratio (OR) = 2.39, 95% CI: 1.24-4.58] and lobar region (OR = 2.83, 95% CI: 1.36-5.86), but not with the number of CMBs (β = 0.14, 95% CI: -0.21-0.48). Among antiplatelet medications, aspirin use was found to be associated with any CMB (OR = 3.17, 95% CI: 1.49-6.72) and lobar CMBs (OR = 3.61, 95% CI: 1.57-8.26).
Conclusions:
Antiplatelet medication was associated with CMBs in stroke-free participants, particularly lobar CMBs. Among antiplatelet medications, aspirin use was associated with any CMB and lobar CMBs. Our findings suggest that it might be essential to optimize the management of antiplatelet medication in the stroke-free population with a higher burden of vascular risk factors to reduce the potential risk of CMBs.
Insights
Antiplatelet medication, particularly aspirin, is linked to cerebral microbleeds (CMBs) in stroke-free individuals. This association is strongest for lobar CMBs, suggesting careful management is needed.
Area of Science:
- Neurology
- Radiology
- Pharmacology
Background:
- Cerebral microbleeds (CMBs) are potential indicators of increased risk for future intracerebral hemorrhage and ischemic stroke.
- The relationship between antiplatelet medication use and the presence of CMBs remains unclear.
- This study investigated the association between antiplatelet agents and CMBs in a community-based, stroke-free cohort.
Purpose of the Study:
- To determine if antiplatelet medication use is associated with cerebral microbleeds (CMBs) in a stroke-free population.
- To explore the association of CMBs with antiplatelet medication based on location (lobar, deep, infratentorial).
- To analyze the relationship between antiplatelet use and the number of CMBs.
Main Methods:
- Cross-sectional study of 544 stroke-free adults aged 18-85 in Beijing, China.
- Data collection included questionnaires for demographics, clinical information, and antiplatelet use; blood tests; and 3.0T brain MRI with susceptibility-weighted imaging for CMB detection.
- Statistical analysis employed multivariable logistic regression for presence/location of CMBs and linear regression for CMB count.
Main Results:
- Of 544 participants, 119 (21.88%) had CMBs and 64 (11.76%) used antiplatelet medication.
- Antiplatelet medication use was significantly associated with any CMB (OR=2.39) and lobar CMBs (OR=2.83), but not CMB count.
- Aspirin use showed a strong association with any CMB (OR=3.17) and lobar CMBs (OR=3.61).
Conclusions:
- Antiplatelet medication use, especially aspirin, is associated with the presence of cerebral microbleeds (CMBs) in stroke-free individuals.
- The association is particularly noted for lobar CMBs.
- Optimizing antiplatelet management in stroke-free individuals with vascular risk factors may be crucial for reducing CMB risk.
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