title: Associations of durations of antiplatelet use and vascular risk factors with the presence of cerebral microbleeds.
abstract: The association of the presence of cerebral microbleeds with antiplatelet use remains controversial. Long durations of antiplatelet use and vascular risk factors may have a greater impact on the development of cerebral microbleeds than short durations. The aim of this study was to determine whether the durations of antiplatelet use and vascular risk factors were associated with the presence of cerebral microbleeds in patients with ischemic cerebrovascular disease, who are frequently treated with antiplatelet agents. Two hundred twenty outpatients with ischemic cerebrovascular lesions (eg, cerebral infarcts and/or white matter lesions) detected by magnetic resonance imaging were examined. Patients with a history of cerebral hemorrhage were excluded. Cerebral microbleeds were observed in 71 (32.3%) patients. Deep or infratentorial microbleeds and strictly lobar microbleeds were observed in 53 (24.1%) patients and 18 (8.2%) patients, respectively. Aspirin use (odds ratio, 2.14; 95% confidence interval [CI], 1.02-4.73; P = .04) and a long duration (≥10 years) of aspirin use (odds ratio, 3.75; 95% CI, 1.31-10.86; P = .01) were significantly associated with deep or infratentorial microbleeds in the crude analysis, but this became nonsignificant after adjustment for hypertension and other confounding factors. The prevalence of antiplatelet use was significantly higher in the patients with hypertension than in those without hypertension (72.5% versus 49.1%, P = .002). Hypertension (odds ratio, 2.50; 95% CI, 1.11-6.41; P = .04) was significantly associated with the development of deep or infratentorial microbleeds even after adjustment for confounding factors and the association increased with the duration of hypertension. In conclusion, we found a significant association between aspirin use and deep or infratentorial microbleeds, but this association may reflect the presence of hypertension as a confounding factor.
authors: Department of Neurology, Juntendo University Shizuoka Hospital, Shizuoka, Japan. Electronic address: kazuo-y@juntendo.ac.jp.
authors: Kazuo
authors: K
authors: Yamashiro
authors: Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan.
authors: Ryota
authors: R
authors: Tanaka
authors: Department of Neurology, Juntendo University Shizuoka Hospital, Shizuoka, Japan.
authors: Yasuyuki
authors: Y
authors: Okuma
authors: Department of Neurology, Juntendo University Urayasu Hospital, Chiba, Japan.
authors: Yuji
authors: Y
authors: Ueno
authors: Department of Neurology, Juntendo University Urayasu Hospital, Chiba, Japan.
authors: Yasutaka
authors: Y
authors: Tanaka
authors: Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan.
authors: Nobutaka
authors: N
authors: Hattori
authors: Department of Neurology, Juntendo University Urayasu Hospital, Chiba, Japan.
authors: Takao
authors: T
authors: Urabe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects*; D002545:Brain Ischemia / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D002543:Cerebral Hemorrhage / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D016009:Chi-Square Distribution; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin
keywords: Antiplatelet agents; cerebral microbleeds; hypertension; ischemic cerebrovascular disease