Skip to main content Accessibility help
×
Home

Aspirin Treatment Increases the Risk of Cerebral Microbleeds

  • Lihong Ge (a1), Guangming Niu (a1) (a2), Xiaodong Han (a2), Yang Gao (a2), Qiong Wu (a2), Hui Wu (a2), Ying Zhang (a2) and Dongling Guo (a2)...

Abstract

Background:

The objective of the study was to determine the frequency of cerebral microbleeds (CMBs) by using phasesensitive imaging in patients with previous transient ischemic attack (TIA) or stroke who were receiving aspirin treatment.

Methods:

We retrospectively analyzed 300 outpatients with ischemic cerebrovascular disease: 150 had been receiving aspirin treatment for >1 year (patients), and 150 controls had not previously received aspirin. Cerebral microbleeds were defined by a trained observer (blinded to clinical details) according to results of T2-weighted, T1-weighted, diffusion-weighted, and phase-sensitive magnetic resonance imaging (MRI). Numerous vascular risk factors including white matter hyperintensity (WMH), duration of aspirin treatment, age, hypertension or diabetes mellitus were investigated for a possible association with the presence of CMBs in the two groups.

Results:

The frequency of CMBs (60/150 (40%) vs 18/150 (12%); odds ratio 4.899, p <0.0001) and intracerebral hemorrhage (ICH)(42/150 (28%) vs 2/150 (1%); odds ratio 28.778, p <0.0001) were significantly higher in the patients than in the controls. Among patients, those using aspirin for >5 years(42/68 (62%) showed a higher frequency of CMBs than those receiving aspirin for ≤ 5 years(18/82 (22%); odds ratio 5.744, p<0.0001). WMH (p=0.020/0.030, 0.007/0.000) age (p=0.007/0.000) and hypertension (p=0.000/0.033), in patients and controls respectively, were each associated with CMBs.

Conclusions:

There was a clear impact of aspirin treatment on CMBs associated with intracerebral hemorrhage in Chinese patients. The frequency of CMBs and hemorrhagic complications was higher in patients treated with long-term aspirin.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Aspirin Treatment Increases the Risk of Cerebral Microbleeds
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Aspirin Treatment Increases the Risk of Cerebral Microbleeds
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Aspirin Treatment Increases the Risk of Cerebral Microbleeds
      Available formats
      ×

Copyright

Corresponding author

Department of Imaging, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing, 100050, China.

References

Hide All
1.Baigent, C, Blackwell, L, Collins, R, et al.Aspirin in the primary and secondary prevention of vascular disease: collaborative metaanalysis of individual participant data from randomised trials. Lancet. 2009;373(9678):184960.
2.Gorelick, PB, Weisman, SM.Risk of hemorrhagic stroke with aspirin use: an update. Stroke. 2005;36(8):18017.
3.Boysen, G.Bleeding complications in secondary stroke prevention by antiplatelet therapy: a benefit-risk analysis. J Intern Med. 1999;246(3):23945.
4.Naidech, AM, Bendok, BR, Garg, RK, et al.Reduced platelet activity is associated with more intraventricular hemorrhage. Neurosurgery. 2009;65(4):68488; discussion 688.
5.Offenbacher, H, Fazekas, F, Schmidt, R, et al.MR of cerebral abnormalities concomitant with primary intracerebral hematomas. AJNR Am J Neuroradiol. 1996;17(3):5738.
6.Fazekas, F, Kleinert, R, Roob, G, et al.Histopathologic analysis of foci of signal loss on gradient-echo T2*-weighted MR images in patients with spontaneous intracerebral hemorrhage: evidence of microangiopathy-related microbleeds. AJNR Am J Neuroradiol. 1999;20(4):63742.
7.Han, J, Gao, P, Lin, Y, et al.Three-tesla magnetic resonance imaging study of cerebral microbleeds in patients with ischemic stroke. Neurol Res. 2009;31(9):9003.
8.Roob, G, Lechner, A, Schmidt, R, et al.Frequency and location of microbleeds in patients with primary intracerebral hemorrhage. Stroke. 2000;31(11):26659.
9.Lovelock, CE, Cordonnier, C, Naka, H, et al.Antithrombotic drug use, cerebral microbleeds, and intracerebral hemorrhage: a systematic review of published and unpublished studies. Stroke. 2010;41(6):12228.
10.Vernooij, MW, Haag, MD, van der Lugt, A, et al.Use of antithrombotic drugs and the presence of cerebral microbleeds: the Rotterdam Scan Study. Arch Neurol. 2009;66(6):71420.
11.Leys, D, Cordonnier, C.Brain microbleeds as a potential risk factor for antiplatelet-related intracerebral haemorrhage. J Neurol Neurosurg Psychiatry. 2010;81(6):58990.
12.Gregoire, SM, Jager, HR, Yousry, TA, et al.Brain microbleeds as a potential risk factor for antiplatelet-related intracerebral haemorrhage: hospital-based, case-control study. J Neurol Neurosurg Psychiatry. 2010;81(6):67984.
13.Soo, YO, Yang, SR, Lam, WW, et al.Risk vs benefit of antithrombotic therapy in ischaemic stroke patients with cerebral microbleeds. J Neurol. 2008;255(11):167986.
14.Orken, DN, Kenangil, G, Uysal, E, et al.Cerebral microbleeds in ischemic stroke patients on warfarin treatment. Stroke. 2009;40(11):363840.
15.Ueno, H, Naka, H, Ohshita, T, et al.Association between cerebral microbleeds on T2*-weighted MR images and recurrent hemorrhagic stroke in patients treated with warfarin following ischemic stroke. AJNR Am J Neuroradiol. 2008;29(8):14836.
16.Nishikawa, T, Ueba, T, Kajiwara, M, et al.Cerebral microbleeds in patients with intracerebral hemorrhage are associated with previous cerebrovascular diseases and white matter hyperintensity, but not with regular use of antiplatelet agents. Neurol Med Chir (Tokyo). 2009;49(8):3339; discussion 338-9.
17.Nandigam, RN, Viswanathan, A, Delgado, P, et al.MR imaging detection of cerebral microbleeds: effect of susceptibilityweighted imaging, section thickness, and field strength. AJNR Am J Neuroradiol. 2009;30(2):33843.
18.Lee, SH, Bae, HJ, Yoon, BW, et al.Low concentration of serum total cholesterol is associated with multifocal signal loss lesions on gradient-echo magnetic resonance imaging: analysis of risk factors for multifocal signal loss lesions. Stroke. 2002;33(12): 28459.
19.Fazekas, F, Chawluk, JB, Alavi, A, et al.MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging. AJR Am J Roentgenol. 1987;149(2):3516.
20.Naidech, AM, Jovanovic, B, Liebling, S, et al.Reduced platelet activity is associated with early clot growth and worse 3-month outcome after intracerebral hemorrhage. Stroke. 2009;40(7): 2398401.
21.Roob, G, Schmidt, R, Kapeller, P, et al.MRI evidence of past cerebral microbleeds in a healthy elderly population. Neurology. 1999;52(5):9914.
22.Liu, PF, Cui, YZ, Na, J, Gao, PY.Cerebral microbleeds - prevalence, distribution and risk factors in northeast population without preceding large-area stroke. Chin Med J (Engl). 2010;123: 28690.
23.Nighoghossian, N, Hermier, M, Adeleine, P, et al.Old microbleeds are a potential risk factor for cerebral bleeding after ischemic stroke: a gradient-echo T2*-weighted brain MRI study. Stroke. 2002; 33(3):73542.
24.Naidech, AM, Bernstein, RA, Levasseur, K, et al.Platelet activity and outcome after intracerebral hemorrhage. Ann Neurol. 2009;65(3):3526.

Aspirin Treatment Increases the Risk of Cerebral Microbleeds

  • Lihong Ge (a1), Guangming Niu (a1) (a2), Xiaodong Han (a2), Yang Gao (a2), Qiong Wu (a2), Hui Wu (a2), Ying Zhang (a2) and Dongling Guo (a2)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed