title: Predictors of New Cerebral Microbleeds in Patients with Antiplatelet Drug Therapy.
abstract: BACKGROUND
  Cerebral microbleeds (CMB) are associated with an increased risk for ischemic and especially hemorrhagic stroke. The aim of the present study is to identify patients at high risk for the development of new CMB after initiation of an antiplatelet drug therapy.
  
  
  METHODS
  Patients received magnetic resonance imaging (MRI) within 1 week after initiation of an antiplatelet drug treatment due to a first ischemic stroke (n = 58) and after a follow-up period of 6 months (n = 40). We documented the presence and the number of CMB at baseline and follow-up and analyzed the influence of possible risk factors including vascular risk factors, stroke etiology, and number of CMB at baseline using stepwise logistic regression and Spearman's correlation coefficient. We compared progression rates of CMB in relation to each risk factor using the Mann-Whitney U-test.
  
  
  RESULTS
  The logistic regression model could correctly predict the presence of CMB in 70.7% of patients at baseline and 80% at follow-up. The model correctly identified 85% of patients with new CMB. We observed progression of CMB in 40% of the patients. The overall progression rate was .8 CMB per patient. The progression rate was significantly influenced by age more than 70 years and atherothrombotic stroke. The number of new CMB correlated significantly with the number of CMB at baseline.
  
  
  CONCLUSIONS
  We found several predictors of CMB after initiation of antiplatelet drug therapy. The results help to identify patients who need closer monitoring and thorough control of risk factors in order to lower the risk of new CMB and associated complications.
authors.affiliation: Epilepsy Center Hessen-Marburg, Department of Neurology, Philipps-University Marburg, Marburg, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Wobith
authors.affiliation: Department of Neuroradiology, Philipps-University Marburg, Marburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Mayer
authors.affiliation: Epilepsy Center Hessen-Marburg, Department of Neurology, Philipps-University Marburg, Marburg, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Belke
authors.affiliation: Epilepsy Center Hessen-Marburg, Department of Neurology, Philipps-University Marburg, Marburg, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Haag
authors.affiliation: Epilepsy Center Hessen-Marburg, Department of Neurology, Philipps-University Marburg, Marburg, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Gerstner
authors.affiliation: Epilepsy Center Hessen-Marburg, Department of Neurology, Philipps-University Marburg, Marburg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Teepker
authors.affiliation: Epilepsy Center Hessen-Marburg, Department of Neurology, Philipps-University Marburg, Marburg, Germany; Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany.
authors.forename: Adam
authors.initials: A
authors.lastname: Strzelczyk
authors.affiliation: Epilepsy Center Hessen-Marburg, Department of Neurology, Philipps-University Marburg, Marburg, Germany.
authors.forename: Rita
authors.initials: R
authors.lastname: Werner
authors.affiliation: Epilepsy Center Hessen-Marburg, Department of Neurology, Philipps-University Marburg, Marburg, Germany; Epilepsy Center Erlangen, Department of Neurology, University Hospitals Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Hajo M
authors.initials: HM
authors.lastname: Hamer
authors.affiliation: Epilepsy Center Hessen-Marburg, Department of Neurology, Philipps-University Marburg, Marburg, Germany; Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Rosenow
authors.affiliation: Epilepsy Center Hessen-Marburg, Department of Neurology, Philipps-University Marburg, Marburg, Germany. Electronic address: hattemer@med.uni-marburg.de.
authors.forename: Katja
authors.initials: K
authors.lastname: Menzler
authors.affiliation: Epilepsy Center Hessen-Marburg, Department of Neurology, Philipps-University Marburg, Marburg, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Knake
mesh_terms: D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000139:chemically induced* / Q000000981:diagnostic imaging; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: CMB; Cerebral microbleeds; antiplatelet drug therapy; hemorrhagic stroke; ischemic stroke; vascular risk factors