Prevalence of brain MRI markers of haemorrhagic risk in patients with stroke and atrial fibrillation
Background and Purpose: Cerebral microbleeds, cortical superficial siderosis, white matter lesions and cerebral atrophy may signify greater bleeding risk particularly in patients in whom anticoagulation is to be considered. We investigated their prevalence and associations with stroke type in patien...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2016-09-01
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| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fneur.2016.00151/full |
| _version_ | 1819020746869964800 |
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| author | Christopher Karayiannis Cathy Soufan Ronil V Chandra Ronil V Chandra Thanh G Phan Thanh G Phan Kitty Wong Shaloo Singhal Lee-Anne Slater John Ly Chris Moran Velandai Srikanth Velandai Srikanth |
| author_facet | Christopher Karayiannis Cathy Soufan Ronil V Chandra Ronil V Chandra Thanh G Phan Thanh G Phan Kitty Wong Shaloo Singhal Lee-Anne Slater John Ly Chris Moran Velandai Srikanth Velandai Srikanth |
| author_sort | Christopher Karayiannis |
| collection | DOAJ |
| description | Background and Purpose: Cerebral microbleeds, cortical superficial siderosis, white matter lesions and cerebral atrophy may signify greater bleeding risk particularly in patients in whom anticoagulation is to be considered. We investigated their prevalence and associations with stroke type in patients with stroke and atrial fibrillation. Material and Methods: Cross-sectional sample, Monash Medical Centre (Melbourne, Australia) between 2010 and 2013, with brain MRI. MRI abnormalities were rated using standardized methods. Logistic regression was used to study associations adjusting for age and sex.Results: There were 170 patients, mean age 78 years (SD 9.8), 154 (90.6%) with ischemic stroke. Prevalence of MRI markers were: any microbleed 49%, multiple (≥2) microbleeds 30%, confluent white matter lesions 18.8%, siderosis 8.9%, severe cerebral atrophy 37.7%. Combinations of the severe manifestations of these markers were much less prevalent (2.9% to 12.4%). Compared with ischemic stroke, those with hemorrhagic stroke were more likely to have ≥10 microbleeds (OR 5.50 95% CI 1.46-20.77, p=0.012) and siderosis (OR 6.24, 95% CI 1.74-22.40, p=0.005). Siderosis was associated with multiple microbleeds (OR 8.14, 95% CI 2.38 - 27.86, p = 0.001). Patients admitted with hemorrhagic stroke and multiple microbleeds were more frequently anticoagulated prior to stroke (6/7, 85.7%) than in those with single (1/2, 50%) or no microbleeds (4/7, 57%). Conclusion: Multiple CMBs, severe WML, and severe cerebral atrophy were common individually in hospitalized patients with stroke and AF, but less so in combination. A higher burden of CMBs may be associated with ICH in stroke patients with AF. |
| first_indexed | 2024-12-21T03:56:07Z |
| format | Article |
| id | doaj.art-9a9cec729f7f491c9f612560e312b25e |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-21T03:56:07Z |
| publishDate | 2016-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-9a9cec729f7f491c9f612560e312b25e2022-12-21T19:16:50ZengFrontiers Media S.A.Frontiers in Neurology1664-22952016-09-01710.3389/fneur.2016.00151213088Prevalence of brain MRI markers of haemorrhagic risk in patients with stroke and atrial fibrillationChristopher Karayiannis0Cathy Soufan1Ronil V Chandra2Ronil V Chandra3Thanh G Phan4Thanh G Phan5Kitty Wong6Shaloo Singhal7Lee-Anne Slater8John Ly9Chris Moran10Velandai Srikanth11Velandai Srikanth12Monash UniversityMonash HealthMonash UniversityMonash HealthMonash UniversityMonash HealthMonash HealthMonash HealthMonash HealthMonash HealthMonash UniversityMonash UniversityMonash HealthBackground and Purpose: Cerebral microbleeds, cortical superficial siderosis, white matter lesions and cerebral atrophy may signify greater bleeding risk particularly in patients in whom anticoagulation is to be considered. We investigated their prevalence and associations with stroke type in patients with stroke and atrial fibrillation. Material and Methods: Cross-sectional sample, Monash Medical Centre (Melbourne, Australia) between 2010 and 2013, with brain MRI. MRI abnormalities were rated using standardized methods. Logistic regression was used to study associations adjusting for age and sex.Results: There were 170 patients, mean age 78 years (SD 9.8), 154 (90.6%) with ischemic stroke. Prevalence of MRI markers were: any microbleed 49%, multiple (≥2) microbleeds 30%, confluent white matter lesions 18.8%, siderosis 8.9%, severe cerebral atrophy 37.7%. Combinations of the severe manifestations of these markers were much less prevalent (2.9% to 12.4%). Compared with ischemic stroke, those with hemorrhagic stroke were more likely to have ≥10 microbleeds (OR 5.50 95% CI 1.46-20.77, p=0.012) and siderosis (OR 6.24, 95% CI 1.74-22.40, p=0.005). Siderosis was associated with multiple microbleeds (OR 8.14, 95% CI 2.38 - 27.86, p = 0.001). Patients admitted with hemorrhagic stroke and multiple microbleeds were more frequently anticoagulated prior to stroke (6/7, 85.7%) than in those with single (1/2, 50%) or no microbleeds (4/7, 57%). Conclusion: Multiple CMBs, severe WML, and severe cerebral atrophy were common individually in hospitalized patients with stroke and AF, but less so in combination. A higher burden of CMBs may be associated with ICH in stroke patients with AF.http://journal.frontiersin.org/Journal/10.3389/fneur.2016.00151/fullAtrial FibrillationStrokeMRImicrohemorrhagemicrobleeds |
| spellingShingle | Christopher Karayiannis Cathy Soufan Ronil V Chandra Ronil V Chandra Thanh G Phan Thanh G Phan Kitty Wong Shaloo Singhal Lee-Anne Slater John Ly Chris Moran Velandai Srikanth Velandai Srikanth Prevalence of brain MRI markers of haemorrhagic risk in patients with stroke and atrial fibrillation Frontiers in Neurology Atrial Fibrillation Stroke MRI microhemorrhage microbleeds |
| title | Prevalence of brain MRI markers of haemorrhagic risk in patients with stroke and atrial fibrillation |
| title_full | Prevalence of brain MRI markers of haemorrhagic risk in patients with stroke and atrial fibrillation |
| title_fullStr | Prevalence of brain MRI markers of haemorrhagic risk in patients with stroke and atrial fibrillation |
| title_full_unstemmed | Prevalence of brain MRI markers of haemorrhagic risk in patients with stroke and atrial fibrillation |
| title_short | Prevalence of brain MRI markers of haemorrhagic risk in patients with stroke and atrial fibrillation |
| title_sort | prevalence of brain mri markers of haemorrhagic risk in patients with stroke and atrial fibrillation |
| topic | Atrial Fibrillation Stroke MRI microhemorrhage microbleeds |
| url | http://journal.frontiersin.org/Journal/10.3389/fneur.2016.00151/full |
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