Prevalence and Risk Factors of Silent Cerebral Microbleeds in Patients with Coronary Artery Disease |
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| Institution: | 1. Departments of Cardiology, Osaka Medical and Pharmaceutical University, Japan;2. Departments of Radiology, Osaka Medical and Pharmaceutical University, Japan;3. Department of Cardiology, Hirakata City Hospital;1. Department of Neurology, Zhejiang Provincial People''s Hospital, People''s Hospital of Hangzhou Medical College, 158 Shangtang Road, Hangzhou, Zhejiang 310014, China;2. Conprehensive Stroke Center, Department of Neurosciences, Spectrum Health Neurosciences, Michigan State University, Grand Rapids, MI 49503, USA;1. Department of Neurosurgery, State University of New York Upstate Medical University, Syracuse, NY, USA;2. Department of Neurology, State University of New York Upstate Medical University, Syracuse, NY, USA;1. Department of Applied Physical Therapy, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil;2. Department of Microbiology, Immunology and Parasitology, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil;3. Department of Neurology Psychology and Psychiatry, Botucatu Medical School, Botucatu, São Paulo, Brazil;4. Clinics Hospital of the Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil;1. Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States;2. Department of Neurosurgery, Brigham and Women''s Hospital, Harvard Medical School, 60 Fenwood Road, BTM 4th floor, Boston, MA 02215, United States;3. Department of Neurosurgery, Mount Sinai Hospital, New York, NY, United States;4. Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States |
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| Abstract: | ObjectivesCerebral microbleeds (CMBs), which can be detected by gradient-echo T2*-weighted magnetic resonance imaging (MRI), represent small chronic brain hemorrhages caused by structural abnormalities in cerebral small vessels. CMBs are known to be a potential predictor of future stroke, and are associated with age, various cardiovascular risk factors, cognitive impairment, and the use of antithrombotic drugs. Patients with coronary artery disease (CAD) are at potentially high risk of CMBs due to the presence of coexistent conditions. However, little is known about CMBs in patients with CAD. We aimed to identify the factors associated with the presence of CMBs among patients with CAD.MethodsWe evaluated 356 consecutive patients mean age, 72 ± 10 years; men = 276 (78%)] with angiographically proven CAD who underwent T2*-weighted brain MRI. The brain MRI was assessed by researchers blinded to the patients’ clinical details.ResultsCMBs were found in 128 (36%) patients. Among 356 patients, 119 (33%) had previously undergone percutaneous coronary intervention (PCI), and 26 (7%) coronary artery bypass grafting (CABG). There was no significant relationship between CMBs and sex, hypertension, dyslipidemia, diabetes mellitus, anticoagulation therapy, antiplatelet therapy, or prior PCI. CMBs were significantly associated with advanced age, previous CABG, eGFR, non-HDL cholesterol, carotid artery disease, long-term antiplatelet therapy, and long-term dual antiplatelet therapy (DAPT) using univariate logistic regression analysis. The multivariate logistic regression analysis showed that long-term antiplatelet therapy (odds ratio, 1.73; 95% CI, 1.06 – 2.84; P = 0.03) or long-term DAPT (odds ratio, 2.92; 95% CI, 1.39 – 6.17; P = 0.004) was significantly associated with CMBs after adjustment for confounding variables.ConclusionsCMBs were frequently observed in patients with CAD and were significantly associated with long-term antiplatelet therapy, especially long-term DAPT. |
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