Association between antiplatelet medication and cerebral microbleeds in stroke-free population

Miao-Xin Yu; Ya-Nan Jia; Dan-Dan Yang; Run-Hua Zhang; Yong Jiang; Gui-Tao Zhang; Hui-Yu Qiao; Hua-Lu Han; Rui Shen; Zi-Han Ning; Xi-Hai Zhao; Gai-Fen Liu; Yong-Jun Wang

doi:10.11909/j.issn.1671-5411.2022.06.002

Association between antiplatelet medication and cerebral microbleeds in stroke-free population

J Geriatr Cardiol. 2022 Jun 28;19(6):409-417. doi: 10.11909/j.issn.1671-5411.2022.06.002.

Authors

Miao-Xin Yu¹, Ya-Nan Jia², Dan-Dan Yang³, Run-Hua Zhang^{1

4}, Yong Jiang^{1

4}, Gui-Tao Zhang¹, Hui-Yu Qiao⁵, Hua-Lu Han⁵, Rui Shen⁵, Zi-Han Ning⁵, Xi-Hai Zhao⁵, Gai-Fen Liu^{1

4

6}, Yong-Jun Wang^{1

4

6}

Affiliations

¹ Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
² Department of Neurology, the Third Hospital of Hebei Medical University, Shijiazhuang, China.
³ Department of Radiology, Beijing Geriatric Hospital, Beijing, China.
⁴ China National Clinical Research Center for Neurological Diseases, Beijing, China.
⁵ Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, China.
⁶ Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China.

PMID: 35845161
PMCID: PMC9248274
DOI: 10.11909/j.issn.1671-5411.2022.06.002

Abstract

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.