title: Antithrombotic drug uses and deep intracerebral hemorrhages in stroke patients with deep cerebral microbleeds.
abstract: BACKGROUND
  It has been suggested that antiplatelet or anticoagulant drugs elevate the rate of intracerebral hemorrhage (ICH) in patients with cerebral microbleeds (MBs). To investigate the mechanism by which antiplatelet drugs or warfarin may contribute to deep ICH occurrences in patients with deep MBs, we prospectively analyzed deep ICH occurrences in 807 consecutive patients (351 females and 456 males; mean age ± standard deviation 69.8 ± 12.0 years) who were admitted to our hospital with strokes.
  
  
  METHODS
  Occurrence-free rate curves were generated using the Kaplan-Meier method; deep ICH occurrence-free rates were compared using the log-rank test. The follow-up period was 0.5 to 71 months (mean ± standard deviation 31.6 ± 22.2 months).
  
  
  RESULTS
  In patients with deep MBs, the rates (1.0%/year; 6 ICHs in 180 patients) of deep ICH occurrence associated with antiplatelet drugs were not significantly greater than that without the drugs (1.0%/year; 6 ICHs in 167 patients; P = .977). The incidence of deep ICHs associated with warfarin use was not significantly greater than that without warfarin use.
  
  
  CONCLUSIONS
  Multivariate analysis revealed that the use of antiplatelet drugs or warfarin did not significantly influence the occurrence of deep ICH in patients with deep MBs. Antiplatelet drugs or warfarin did not significantly elevate the rate of deep ICHs in stroke patients with pre-existing deep MBs.
authors.affiliation: Department of Neurosurgery, Kushiro City General Hospital, Hokkaido, Japan. timaizum@d9.dion.ne.jp
authors.forename: Toshio
authors.initials: T
authors.lastname: Imaizumi
authors.forename: Shigeru
authors.initials: S
authors.lastname: Inamura
authors.forename: Ikuhide
authors.initials: I
authors.lastname: Kohama
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Yoshifuji
authors.forename: Tatsufumi
authors.initials: T
authors.lastname: Nomura
authors.forename: Katsuya
authors.initials: K
authors.lastname: Komatsu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects*; D002543:Cerebral Hemorrhage / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects*; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D014859:Warfarin / Q000009:adverse effects*
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin