Detection of cerebral microbleeds in patients treated with oral anticoagulants

2008 ◽  
Vol 35 (S 01) ◽  
Author(s):  
H Wersching ◽  
C Stehling ◽  
P Kirchhof ◽  
W Heindel ◽  
S Knecht
Keyword(s):  
Oral Anticoagulants ◽  
Cerebral Microbleeds

Correlation of non-vitamin K antagonist oral anticoagulant exposure and cerebral microbleeds in Chinese patients with atrial fibrillation

2018 ◽  
Vol 89 (7) ◽  
pp. 680-686 ◽  
Author(s):  
Yannie Soo ◽  
Jill Abrigo ◽  
Kam Tat Leung ◽  
Wenyan Liu ◽  
Bonnie Lam ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
White Matter ◽  
Vitamin K ◽  
Intracerebral Haemorrhage ◽  
Oral Anticoagulants ◽  
Vitamin K Antagonist ◽  
Cerebral Microbleeds ◽  
Chinese Patients ◽  
Control Group

Background and purposeCerebral microbleeds (CMBs) are radiological markers which predict future intracerebral haemorrhage. Researchers are exploring how CMBs can guide anticoagulation decisions in atrial fibrillation (AF). The purpose of this study is to evaluate the correlation of non-vitamin K antagonist oral anticoagulants (NOAC) exposure and prevalence of CMBs in Chinese patients with AF.MethodsWe prospectively recruited Chinese patients with AF on NOAC therapy of ≥30 days for 3T MRI brain for evaluation of CMBs and white matter hyperintensities. Patients with AF without prior exposure to oral anticoagulation were recruited as control group.ResultsA total of 282 patients were recruited, including 124 patients in NOAC group and 158 patients in control group. Mean duration of NOAC exposure was 723.8±500.3 days. CMBs were observed in 103 (36.5%) patients. No significant correlation was observed between duration of NOAC exposure and quantity of CMBs. After adjusting for confounding factors (ie, age, hypertension, labile hypertension, stroke history and white matter scores), previous intracerebral haemorrhage was predictive of CMBs (OR 15.28, 95% CI 1.81 to 129.16), particularly lobar CMBs (OR 5.37, 95% CI 1.27 to 22.6). While white matter score was predictive of mixed lobar CMBs (OR 1.65, 95% CI 1.1 to 2.5), both exposure and duration of NOAC use were not predictive of presence of CMBs.ConclusionsIn Chinese patients with AF, duration of NOAC exposure did not correlate with prevalence and burden of CMBs. Further studies with follow-up MRI are needed to determine if long-term NOAC therapy can lead to development of new CMBs.

scholarly journals Non-Vitamin K Antagonist Oral Anticoagulants Do Not Increase Cerebral Microbleeds

2015 ◽  
Vol 24 (6) ◽  
pp. 1373-1377 ◽  
Author(s):  
Tsukasa Saito ◽  
Yuichiro Kawamura ◽  
Nobuyuki Sato ◽  
Kohei Kano ◽  
Kae Takahashi ◽  
...  
Keyword(s):  
Vitamin K ◽  
Oral Anticoagulants ◽  
Vitamin K Antagonist ◽  
Cerebral Microbleeds

Risk of intracerebral haemorrhage in Chinese patients with atrial fibrillation on warfarin with cerebral microbleeds: the IPAAC-Warfarin study

2018 ◽  
Vol 90 (4) ◽  
pp. 428-435 ◽  
Author(s):  
Yannie Soo ◽  
Jill M Abrigo ◽  
Kam Tat Leung ◽  
Suk Fung Tsang ◽  
Hing Lung Ip ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischaemic Stroke ◽  
Intracerebral Haemorrhage ◽  
Primary Outcome ◽  
Oral Anticoagulants ◽  
Final Analysis ◽  
Cerebral Microbleeds ◽  
Chinese Patients ◽  
The Mean

Background and purposeCerebral microbleeds (CMBs), which predict future intracerebral haemorrhage (ICH), may guide anticoagulant decisions for atrial fibrillation (AF). We aimed to evaluate the risk of warfarin-associated ICH in Chinese patients with AF with CMBs.MethodsIn this prospective, observational, multicentre study, we recruited Chinese patients with AF who were on or intended to start anticoagulation with warfarin from six hospitals in Hong Kong. CMBs were evaluated with 3T MRI brain at baseline. Primary outcome was clinical ICH at 2-year follow-up. Secondary outcomes were ischaemic stroke, systemic embolism, mortality of all causes and modified Rankin Scale ≥3. Outcome events were compared between patients with and without CMBs.ResultsA total of 290 patients were recruited; 53 patients were excluded by predefined criteria. Among the 237 patients included in the final analysis, CMBs were observed in 84 (35.4%) patients, and 11 had ≥5 CMBs. The mean follow-up period was 22.4±10.3 months. Compared with patients without CMBs, patients with CMBs had numerically higher rate of ICH (3.6% vs 0.7%, p=0.129). The rate of ICH was lower than ischaemic stroke for patients with 0 to 4 CMBs, but higher for those with ≥5 CMBs. CMB count (C-index 0.82) was more sensitive than HAS-BLED (C-index 0.55) and CHA2DS2-VASc (C-index 0.63) scores in predicting ICH.ConclusionsIn Chinese patients with AF on warfarin, presence of multiple CMBs may be associated with higher rate of ICH than ischaemic stroke. Larger studies through international collaboration are needed to determine the risk:benefit ratio of oral anticoagulants in patients with AF of different ethnic origins.

PS 11-80 NON-VITAMIN K ANTAGONIST ORAL ANTICOAGULANTS DO NOT INCREASE CEREBRAL MICROBLEEDS

2016 ◽  
Vol 34 (Supplement 1) ◽  
pp. e354
Author(s):  
Tsukasa Saito ◽  
Yuichiro Kawaura ◽  
Nobuyuki Sato ◽  
Naoyuki Hasebe
Keyword(s):  
Vitamin K ◽  
Oral Anticoagulants ◽  
Vitamin K Antagonist ◽  
Cerebral Microbleeds

Detection of cerebral microbleeds in patients treated with oral anticoagulants

2009 ◽  
Vol 283 (1-2) ◽  
pp. 278
Author(s):  
H. Wersching ◽  
C. Stehling ◽  
S. Kloska ◽  
L. Eckardt ◽  
W. Heindel ◽  
...  
Keyword(s):  
Oral Anticoagulants ◽  
Cerebral Microbleeds

scholarly journals Atrial fibrillation and cognitive impairment: cerebral microbleeds as a new risk factor and possibilities of anticoagulant therapy (Part 2)

2020 ◽  
Vol 12 (4) ◽  
pp. 107-112
Author(s):  
O. D. Ostroumova ◽  
A. I. Kochetkov ◽  
T. M. Ostroumova
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Cognitive Impairment ◽  
Oral Anticoagulants ◽  
Cerebral Microbleeds ◽  
Controlled Clinical Trial ◽  
Modern Health Care ◽  
High Prevalence ◽  
Negative Effect ◽  
Meta Analyses

Atrial fibrillation (AF) and cognitive impairment (CI) are among the most important problems of the modern health care system, which are characterized by an extremely high prevalence with the increasing trend of the latter; they lead to lower quality of life, shorter duration, and a larger number of disabled people. The specific feature of AF and CI is the presence of common risk factors. To date, the data of an increasing number of studies allow cerebral microbleeds (CMBs) to be considered as a new risk factor for CI, inter alia in patients with AF. In recent years, special attention has been paid to the role of oral anticoagulants (OACs) in the prevention of CI in AF, which is reflected in a number of studies and meta-analyses. In terms of the effect of OACs on the risk of CMBs, there is reason to believe that the latter increases with the use of warfarin, the effects of direct OACs (DOAC) in this regard require further investigation. At the same time, among the DOACs, apixaban is the only drug that has been proven to have no negative effect on the risk of CMBs in a randomized controlled clinical trial. In general, the available data indicate the positive effect of OACs in reducing the risk of CI and dementia in AF; moreover, DOACs have an advantage in this respect. Among the DOACs, apixaban is promising due to its optimal efficacy and safety profile.

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