Predictors of New Cerebral Microbleeds in Patients with Antiplatelet Drug Therapy

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• 作者：Maria Wobith ; MD^* ; Christian Mayer ; MD^&dagger ; ; Marcus Belke ; MD^* ; Anja Haag ; MSc^* ; Anja Gerstner ; MD^* ; Michael Teepker ; MD^* ; Adam Strzelczyk ; MD^* ; ^&Dagger ; ; Rita Werner^* ; Hajo M. Hamer ; MD^* ; ^§ ; ; Felix Rosenow ; MD^* ; ^&Dagger ; ; Katja Menzler ; MD^* ; ¹ ; ^{hattemer@med.uni-marburg.de" class="auth_mail" title="E-mail the corresponding author} ; Susanne Knake ; MD^* ; ¹
• 关键词：Cerebral microbleeds ; CMB ; antiplatelet drug therapy ; ischemic stroke ; vascular risk factors ; hemorrhagic stroke
• 刊名：Journal of Stroke and Cerebrovascular Diseases
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：25
• 期：7
• 页码：1671-1677
• 全文大小：240 K

文摘

Cerebral microbleeds (CMB) are associated with an increased risk for ischemic and especially hemorrhagic stroke. The aim of the present study is to identify patients at high risk for the development of new CMB after initiation of an antiplatelet drug therapy.

Methods

Patients received magnetic resonance imaging (MRI) within 1 week after initiation of an antiplatelet drug treatment due to a first ischemic stroke (n = 58) and after a follow-up period of 6 months (n = 40). We documented the presence and the number of CMB at baseline and follow-up and analyzed the influence of possible risk factors including vascular risk factors, stroke etiology, and number of CMB at baseline using stepwise logistic regression and Spearman's correlation coefficient. We compared progression rates of CMB in relation to each risk factor using the Mann–Whitney U-test.

Results

The logistic regression model could correctly predict the presence of CMB in 70.7% of patients at baseline and 80% at follow-up. The model correctly identified 85% of patients with new CMB. We observed progression of CMB in 40% of the patients. The overall progression rate was .8 CMB per patient. The progression rate was significantly influenced by age more than 70 years and atherothrombotic stroke. The number of new CMB correlated significantly with the number of CMB at baseline.

Conclusions

We found several predictors of CMB after initiation of antiplatelet drug therapy. The results help to identify patients who need closer monitoring and thorough control of risk factors in order to lower the risk of new CMB and associated complications.