Prevalence of atrial fibrillation and association of previous antithrombotic treatment in patients with cerebral microbleeds
Standard
Prevalence of atrial fibrillation and association of previous antithrombotic treatment in patients with cerebral microbleeds. / Horstmann, S; Möhlenbruch, M; Wegele, C; Rizos, T; Laible, M; Rauch, G; Veltkamp, R.
in: EUR J NEUROL, Jahrgang 22, Nr. 10, 10.2015, S. 1355-1362.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Prevalence of atrial fibrillation and association of previous antithrombotic treatment in patients with cerebral microbleeds
AU - Horstmann, S
AU - Möhlenbruch, M
AU - Wegele, C
AU - Rizos, T
AU - Laible, M
AU - Rauch, G
AU - Veltkamp, R
N1 - © 2014 EAN.
PY - 2015/10
Y1 - 2015/10
N2 - BACKGROUND AND PURPOSE: Cerebral microbleeds (CMBs) are associated with an increased risk of intracerebral hemorrhage. The impact of oral anticoagulation (OAC) on CMBs is not well characterized. Our aim was to assess the prevalence of CMBs in stroke and transient ischaemic attack (TIA) patients with atrial fibrillation (AF) and to analyze the implications of previous treatment with OAC.METHODS: In this retrospective analysis on data from a prospectively recruiting stroke registry, patients with ischaemic stroke or TIA with brain magnetic resonance imaging including susceptibility weighted imaging were consecutively enrolled during a 3-year period. For each patient cardiovascular risk factors, AF history and recent diagnosis of AF, present use of OAC and antiplatelets, the National Institute of Health Stroke Scale and the premorbid modified Rankin Scale score were recorded. Two independent raters identified CMBs according to consensus criteria. CMB location was classified as lobar, deep or in the posterior fossa.RESULTS: In all, 785 patients (mean age 63.9 ± 14.2 years) were included. At least one CMB was detected in 186 (23.7%) patients. CMBs were significantly more frequent in patients with AF (30.5% vs. 22.4%). Patients with previous OAC treatment were more likely to have CMBs (36.7% vs. 22.8%, P = 0.03) and abundant CMBs (n > 10) were more frequent in anticoagulated patients even after adjustment for age. However, age was the only independent factor predicting CMBs (P = 0.001).CONCLUSIONS: Cerebral microbleeds are common in elderly AF patients with acute ischaemic stroke. Previous OAC is associated with a higher number of CMBs predominantly in the lobar location. Establishing a causal relationship requires prospective longitudinal investigation.
AB - BACKGROUND AND PURPOSE: Cerebral microbleeds (CMBs) are associated with an increased risk of intracerebral hemorrhage. The impact of oral anticoagulation (OAC) on CMBs is not well characterized. Our aim was to assess the prevalence of CMBs in stroke and transient ischaemic attack (TIA) patients with atrial fibrillation (AF) and to analyze the implications of previous treatment with OAC.METHODS: In this retrospective analysis on data from a prospectively recruiting stroke registry, patients with ischaemic stroke or TIA with brain magnetic resonance imaging including susceptibility weighted imaging were consecutively enrolled during a 3-year period. For each patient cardiovascular risk factors, AF history and recent diagnosis of AF, present use of OAC and antiplatelets, the National Institute of Health Stroke Scale and the premorbid modified Rankin Scale score were recorded. Two independent raters identified CMBs according to consensus criteria. CMB location was classified as lobar, deep or in the posterior fossa.RESULTS: In all, 785 patients (mean age 63.9 ± 14.2 years) were included. At least one CMB was detected in 186 (23.7%) patients. CMBs were significantly more frequent in patients with AF (30.5% vs. 22.4%). Patients with previous OAC treatment were more likely to have CMBs (36.7% vs. 22.8%, P = 0.03) and abundant CMBs (n > 10) were more frequent in anticoagulated patients even after adjustment for age. However, age was the only independent factor predicting CMBs (P = 0.001).CONCLUSIONS: Cerebral microbleeds are common in elderly AF patients with acute ischaemic stroke. Previous OAC is associated with a higher number of CMBs predominantly in the lobar location. Establishing a causal relationship requires prospective longitudinal investigation.
KW - Aged
KW - Aged, 80 and over
KW - Anticoagulants
KW - Atrial Fibrillation
KW - Cerebral Hemorrhage
KW - Comorbidity
KW - Female
KW - Humans
KW - Ischemic Attack, Transient
KW - Male
KW - Middle Aged
KW - Prevalence
KW - Prospective Studies
KW - Registries
KW - Retrospective Studies
KW - Stroke
KW - Journal Article
KW - Observational Study
KW - Research Support, Non-U.S. Gov't
U2 - 10.1111/ene.12608
DO - 10.1111/ene.12608
M3 - SCORING: Journal article
C2 - 25557113
VL - 22
SP - 1355
EP - 1362
JO - EUR J NEUROL
JF - EUR J NEUROL
SN - 1351-5101
IS - 10
ER -