title: Association of cerebral microbleeds with mortality in stroke patients having atrial fibrillation.
abstract: OBJECTIVE
  We investigated the association of cerebral microbleeds (CMBs) with long-term mortality in patients with nonvalvular atrial fibrillation (NVAF) according to burden and distribution of CMBs.
  
  
  METHODS
  This was a retrospective, hospital-based, observational study. In total, 504 consecutive ischemic stroke patients with NVAF who underwent brain T2-weighted, gradient-recalled echo MRI were included. Data for the date and causes of death were based on the death certificates from the Korean National Statistical Office. We determined the association of the presence, burden, and distribution of CMBs with mortality from all-cause, ischemic heart disease, ischemic stroke, and hemorrhagic stroke.
  
  
  RESULTS
  CMBs were found in 30.7% of patients (155/504). During a median follow-up of 2.5 years, 176 patients (34.9%) died (ischemic stroke, 81; hemorrhagic stroke, 12; ischemic heart disease, 32). Patients with CMBs died more frequently than those without (41.9% vs 31.8%, p = 0.028). After adjusting for age, sex, and other significant variables, the presence of multiple (≥5) CMBs was as an independent predictor for all-cause (hazard ratio [HR]: 1.99) and ischemic stroke (HR: 3.39) mortality. Patients with strictly lobar CMBs had an increased risk of hemorrhagic stroke mortality (HR: 5.91).
  
  
  CONCLUSIONS
  The presence and burden of CMBs were associated with increased mortality in stroke patients with NVAF. Patients with lobar CMBs were at increased risk of death due to hemorrhagic stroke. The diagnosis of CMBs is of value in predicting long-term prognosis in stroke patients with NVAF.
authors.affiliation: From the Departments of Neurology (T.-J.S., D.S., H.S.N., Y.D.K., J.H.H.) and Biostatistics (H.S.L.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Ewha Womans University School of Medicine, Seoul; and Department of Neurology (J.K.), CHA Bundang Medical Centre, CHA University, Seongnam, Korea.
authors.forename: Tae-Jin
authors.initials: TJ
authors.lastname: Song
authors.affiliation: From the Departments of Neurology (T.-J.S., D.S., H.S.N., Y.D.K., J.H.H.) and Biostatistics (H.S.L.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Ewha Womans University School of Medicine, Seoul; and Department of Neurology (J.K.), CHA Bundang Medical Centre, CHA University, Seongnam, Korea.
authors.forename: Jinkwon
authors.initials: J
authors.lastname: Kim
authors.affiliation: From the Departments of Neurology (T.-J.S., D.S., H.S.N., Y.D.K., J.H.H.) and Biostatistics (H.S.L.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Ewha Womans University School of Medicine, Seoul; and Department of Neurology (J.K.), CHA Bundang Medical Centre, CHA University, Seongnam, Korea.
authors.forename: Dongbeom
authors.initials: D
authors.lastname: Song
authors.affiliation: From the Departments of Neurology (T.-J.S., D.S., H.S.N., Y.D.K., J.H.H.) and Biostatistics (H.S.L.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Ewha Womans University School of Medicine, Seoul; and Department of Neurology (J.K.), CHA Bundang Medical Centre, CHA University, Seongnam, Korea.
authors.forename: Hyo Suk
authors.initials: HS
authors.lastname: Nam
authors.affiliation: From the Departments of Neurology (T.-J.S., D.S., H.S.N., Y.D.K., J.H.H.) and Biostatistics (H.S.L.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Ewha Womans University School of Medicine, Seoul; and Department of Neurology (J.K.), CHA Bundang Medical Centre, CHA University, Seongnam, Korea.
authors.forename: Young Dae
authors.initials: YD
authors.lastname: Kim
authors.affiliation: From the Departments of Neurology (T.-J.S., D.S., H.S.N., Y.D.K., J.H.H.) and Biostatistics (H.S.L.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Ewha Womans University School of Medicine, Seoul; and Department of Neurology (J.K.), CHA Bundang Medical Centre, CHA University, Seongnam, Korea.
authors.forename: Hye Sun
authors.initials: HS
authors.lastname: Lee
authors.affiliation: From the Departments of Neurology (T.-J.S., D.S., H.S.N., Y.D.K., J.H.H.) and Biostatistics (H.S.L.), Yonsei University College of Medicine, Seoul; Department of Neurology (T.-J.S.), Ewha Womans University School of Medicine, Seoul; and Department of Neurology (J.K.), CHA Bundang Medical Centre, CHA University, Seongnam, Korea. jhheo@yuhs.ac.
authors.forename: Ji Hoe
authors.initials: JH
authors.lastname: Heo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications* / Q000401:mortality*; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000401:mortality*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications* / Q000401:mortality*