title: Cerebral Microbleeds Do Not Predict Hemorrhagic Transformation in Acute Ischemic Stroke Patients with Atrial Fibrillation and/or Rheumatic Heart Disease.
abstract: Cerebral microbleeds (CMBs) are known to be potential risk factors for intracerebral hemorrhage (ICH), but there is controversy on the relationship between CMBs and hemorrhagic transformation (HT) after ischemic stroke. Besides, the question regarding whether the relationship between CMBs and HT can be affected by antithrombotic drugs in acute stage of ischemic stroke has not yet reached a consensus.
  
  
  
  174 acute ischemic stroke patients with atrial fibrillation (AF) and/or rheumatic heart disease (RHD) were prospectively and consecutively enrolled in the study, of which 160 patients (mean 68.09 ±12.59 years) were finally included in the final analysis (West China Hospital, Sichuan University, n=125; People's Hospital of Deyang City, n=35).We assessed the presence, location and number of CMBs by using susceptibility-weighted imaging (SWI) within 7 days after admission, and the incidence of hemorrhagic transformation was evaluated by magnetic resonance imaging(MRI) during hospitalization. The univariate and multivariate analyses were used to analyze the relationship between CMBs and HT.
  
  
  
  CMBs were detected in 90 patients (56.3%). HT was found in 62 (38.8%) patients, among which 43 were hemorrhagic infarction (HI) and 19 were parenchymal haemorrhage (PH). The presence of CMBs was not significantly different among different HT subtypes (no HT, HI and PH; 59.2%, 51.2%, versus 52.6%, P=0.64). There was no relationship between the number/location of CMBs and hemorrhagic transformation subtypes (P=0.38). In the 2 subgroups of patients treated with anticoagulants and antiplatelets after admission, the incidence of HT was not significantly different between patients with and without CMBs (anticoagulants, 13.3% versus 18.2%, P=0.71; antiplatelets, 29.2% versus 40.3%, P= 0.21).
  
  
  
  The present study suggests that CMBs do not predict the presence of hemorrhagic transformation in acute ischemic stroke patients with AF and/or RHD. The results were not affected by anticoagulant or antiplatelet agents used in acute stage of ischemic stroke.
authors.affiliation: Department of Neurology, Stroke Clinical Research Unit, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Junfeng
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Neurology, Stroke Clinical Research Unit, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Deren
authors.initials: D
authors.lastname: Wang
authors.affiliation: Department of Neurology, People&#39;s Hospital of Deyang City, Deyang, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Neurology, Stroke Clinical Research Unit, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Lin
authors.affiliation: Department of Neurology, Stroke Clinical Research Unit, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Xiong
authors.affiliation: Department of Neurology, Stroke Clinical Research Unit, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Bian
authors.initials: B
authors.lastname: Liu
authors.affiliation: Department of Neurology, Stroke Clinical Research Unit, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Chenchen
authors.initials: C
authors.lastname: Wei
authors.affiliation: Department of Neurology, Stroke Clinical Research Unit, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Wu
authors.affiliation: Department of Neurology, Stroke Clinical Research Unit, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Zhenxing
authors.initials: Z
authors.lastname: Ma
authors.affiliation: Department of Neurology, Stroke Clinical Research Unit, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Shihong
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, No. 37, GuoXue Xiang, Chengdu, 610041, Sichuan Province, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications* / Q000000981:diagnostic imaging; D002545:Brain Ischemia / Q000150:complications* / Q000000981:diagnostic imaging; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012214:Rheumatic Heart Disease / Q000150:complications* / Q000000981:diagnostic imaging; D020521:Stroke / Q000150:complications* / Q000000981:diagnostic imaging / Q000209:etiology*; D055815:Young Adult
keywords: Cerebral microbleeds; arial fibrillation; hemorrhagic transformation; ischemic stroke; rheumatic heart disease