Cargando…

Association of statin use and lipid levels with cerebral microbleeds and intracranial hemorrhage in patients with atrial fibrillation: A prospective cohort study

BACKGROUND: An increased risk of intracranial hemorrhage (ICH) associated with statins has been reported, but data on the relationship between statin use and cerebral microbleeds (CMBs) in patients with atrial fibrillation (AF), a population at high bleeding and cardiovascular risk, are lacking. AIM...

Descripción completa

Detalles Bibliográficos
Autores principales: Moutzouri, Elisavet, Glutz, Matthias, Abolhassani, Nazanin, Feller, Martin, Adam, Luise, Gencer, Baris, Del Giovane, Cinzia, Bétrisey, Sylvain, Paladini, Rebecca E, Hennings, Elisa, Aeschbacher, Stefanie, Beer, Jürg H, Moschovitis, Giorgio, Seiffge, David, De Marchis, Gian Marco, Coslovsky, Michael, Reichlin, Tobias, Conte, Giulio, Sinnecker, Tim, Schwenkglenks, Matthias, Bonati, Leo H, Kastner, Peter, Aujesky, Drahomir, Kühne, Michael, Osswald, Stefan, Fischer, Urs, Conen, David, Rodondi, Nicolas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10676039/
https://www.ncbi.nlm.nih.gov/pubmed/37243540
http://dx.doi.org/10.1177/17474930231181010
_version_ 1785149895486734336
author Moutzouri, Elisavet
Glutz, Matthias
Abolhassani, Nazanin
Feller, Martin
Adam, Luise
Gencer, Baris
Del Giovane, Cinzia
Bétrisey, Sylvain
Paladini, Rebecca E
Hennings, Elisa
Aeschbacher, Stefanie
Beer, Jürg H
Moschovitis, Giorgio
Seiffge, David
De Marchis, Gian Marco
Coslovsky, Michael
Reichlin, Tobias
Conte, Giulio
Sinnecker, Tim
Schwenkglenks, Matthias
Bonati, Leo H
Kastner, Peter
Aujesky, Drahomir
Kühne, Michael
Osswald, Stefan
Fischer, Urs
Conen, David
Rodondi, Nicolas
author_facet Moutzouri, Elisavet
Glutz, Matthias
Abolhassani, Nazanin
Feller, Martin
Adam, Luise
Gencer, Baris
Del Giovane, Cinzia
Bétrisey, Sylvain
Paladini, Rebecca E
Hennings, Elisa
Aeschbacher, Stefanie
Beer, Jürg H
Moschovitis, Giorgio
Seiffge, David
De Marchis, Gian Marco
Coslovsky, Michael
Reichlin, Tobias
Conte, Giulio
Sinnecker, Tim
Schwenkglenks, Matthias
Bonati, Leo H
Kastner, Peter
Aujesky, Drahomir
Kühne, Michael
Osswald, Stefan
Fischer, Urs
Conen, David
Rodondi, Nicolas
author_sort Moutzouri, Elisavet
collection PubMed
description BACKGROUND: An increased risk of intracranial hemorrhage (ICH) associated with statins has been reported, but data on the relationship between statin use and cerebral microbleeds (CMBs) in patients with atrial fibrillation (AF), a population at high bleeding and cardiovascular risk, are lacking. AIMS: To explore the association between statin use and blood lipid levels with the prevalence and progression of CMBs in patients with AF with a particular focus on anticoagulated patients. METHODS: Data of Swiss-AF, a prospective cohort of patients with established AF, were analyzed. Statin use was assessed during baseline and throughout follow-up. Lipid values were measured at baseline. CMBs were assessed using magnetic resonance imagining (MRI) at baseline and at 2 years follow-up. Imaging data were centrally assessed by blinded investigators. Associations of statin use and low-density lipoprotein (LDL) levels with CMB prevalence at baseline or CMB progression (at least one additional or new CMB on follow-up MRI at 2 years compared with baseline) were assessed using logistic regression models; the association with ICH was assessed using flexible parametric survival models. Models were adjusted for hypertension, smoking, body mass index, diabetes, stroke/transient ischemic attack, coronary heart disease, antiplatelet use, anticoagulant use, and education. RESULTS: Of the 1693 patients with CMB data at baseline MRI (mean ± SD age 72.5 ± 8.4 years, 27.6% women, 90.1% on oral anticoagulants), 802 patients (47.4%) were statin users. The multivariable adjusted odds ratio (adjOR) for CMBs prevalence at baseline for statin users was 1.10 (95% CI = 0.83–1.45). AdjOR for 1 unit increase in LDL levels was 0.95 (95% CI = 0.82–1.10). At 2 years, 1188 patients had follow-up MRI. CMBs progression was observed in 44 (8.0%) statin users and 47 (7.4%) non-statin users. Of these patients, 64 (70.3%) developed a single new CMB, 14 (15.4%) developed 2 CMBs, and 13 developed more than 3 CMBs. The multivariable adjOR for statin users was 1.09 (95% CI = 0.66–1.80). There was no association between LDL levels and CMB progression (adjOR 1.02, 95% CI = 0.79–1.32). At follow-up 14 (1.2%) statin users had ICH versus 16 (1.3%) non-users. The age and sex adjusted hazard ratio (adjHR) was 0.75 (95% CI = 0.36–1.55). The results remained robust in sensitivity analyses excluding participants without anticoagulants. CONCLUSIONS: In this prospective cohort of patients with AF, a population at increased hemorrhagic risk due to anticoagulation, the use of statins was not associated with an increased risk of CMBs.
format Online
Article
Text
id pubmed-10676039
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-106760392023-11-25 Association of statin use and lipid levels with cerebral microbleeds and intracranial hemorrhage in patients with atrial fibrillation: A prospective cohort study Moutzouri, Elisavet Glutz, Matthias Abolhassani, Nazanin Feller, Martin Adam, Luise Gencer, Baris Del Giovane, Cinzia Bétrisey, Sylvain Paladini, Rebecca E Hennings, Elisa Aeschbacher, Stefanie Beer, Jürg H Moschovitis, Giorgio Seiffge, David De Marchis, Gian Marco Coslovsky, Michael Reichlin, Tobias Conte, Giulio Sinnecker, Tim Schwenkglenks, Matthias Bonati, Leo H Kastner, Peter Aujesky, Drahomir Kühne, Michael Osswald, Stefan Fischer, Urs Conen, David Rodondi, Nicolas Int J Stroke Research BACKGROUND: An increased risk of intracranial hemorrhage (ICH) associated with statins has been reported, but data on the relationship between statin use and cerebral microbleeds (CMBs) in patients with atrial fibrillation (AF), a population at high bleeding and cardiovascular risk, are lacking. AIMS: To explore the association between statin use and blood lipid levels with the prevalence and progression of CMBs in patients with AF with a particular focus on anticoagulated patients. METHODS: Data of Swiss-AF, a prospective cohort of patients with established AF, were analyzed. Statin use was assessed during baseline and throughout follow-up. Lipid values were measured at baseline. CMBs were assessed using magnetic resonance imagining (MRI) at baseline and at 2 years follow-up. Imaging data were centrally assessed by blinded investigators. Associations of statin use and low-density lipoprotein (LDL) levels with CMB prevalence at baseline or CMB progression (at least one additional or new CMB on follow-up MRI at 2 years compared with baseline) were assessed using logistic regression models; the association with ICH was assessed using flexible parametric survival models. Models were adjusted for hypertension, smoking, body mass index, diabetes, stroke/transient ischemic attack, coronary heart disease, antiplatelet use, anticoagulant use, and education. RESULTS: Of the 1693 patients with CMB data at baseline MRI (mean ± SD age 72.5 ± 8.4 years, 27.6% women, 90.1% on oral anticoagulants), 802 patients (47.4%) were statin users. The multivariable adjusted odds ratio (adjOR) for CMBs prevalence at baseline for statin users was 1.10 (95% CI = 0.83–1.45). AdjOR for 1 unit increase in LDL levels was 0.95 (95% CI = 0.82–1.10). At 2 years, 1188 patients had follow-up MRI. CMBs progression was observed in 44 (8.0%) statin users and 47 (7.4%) non-statin users. Of these patients, 64 (70.3%) developed a single new CMB, 14 (15.4%) developed 2 CMBs, and 13 developed more than 3 CMBs. The multivariable adjOR for statin users was 1.09 (95% CI = 0.66–1.80). There was no association between LDL levels and CMB progression (adjOR 1.02, 95% CI = 0.79–1.32). At follow-up 14 (1.2%) statin users had ICH versus 16 (1.3%) non-users. The age and sex adjusted hazard ratio (adjHR) was 0.75 (95% CI = 0.36–1.55). The results remained robust in sensitivity analyses excluding participants without anticoagulants. CONCLUSIONS: In this prospective cohort of patients with AF, a population at increased hemorrhagic risk due to anticoagulation, the use of statins was not associated with an increased risk of CMBs. SAGE Publications 2023-06-17 2023-12 /pmc/articles/PMC10676039/ /pubmed/37243540 http://dx.doi.org/10.1177/17474930231181010 Text en © 2023 World Stroke Organization https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Research
Moutzouri, Elisavet
Glutz, Matthias
Abolhassani, Nazanin
Feller, Martin
Adam, Luise
Gencer, Baris
Del Giovane, Cinzia
Bétrisey, Sylvain
Paladini, Rebecca E
Hennings, Elisa
Aeschbacher, Stefanie
Beer, Jürg H
Moschovitis, Giorgio
Seiffge, David
De Marchis, Gian Marco
Coslovsky, Michael
Reichlin, Tobias
Conte, Giulio
Sinnecker, Tim
Schwenkglenks, Matthias
Bonati, Leo H
Kastner, Peter
Aujesky, Drahomir
Kühne, Michael
Osswald, Stefan
Fischer, Urs
Conen, David
Rodondi, Nicolas
Association of statin use and lipid levels with cerebral microbleeds and intracranial hemorrhage in patients with atrial fibrillation: A prospective cohort study
title Association of statin use and lipid levels with cerebral microbleeds and intracranial hemorrhage in patients with atrial fibrillation: A prospective cohort study
title_full Association of statin use and lipid levels with cerebral microbleeds and intracranial hemorrhage in patients with atrial fibrillation: A prospective cohort study
title_fullStr Association of statin use and lipid levels with cerebral microbleeds and intracranial hemorrhage in patients with atrial fibrillation: A prospective cohort study
title_full_unstemmed Association of statin use and lipid levels with cerebral microbleeds and intracranial hemorrhage in patients with atrial fibrillation: A prospective cohort study
title_short Association of statin use and lipid levels with cerebral microbleeds and intracranial hemorrhage in patients with atrial fibrillation: A prospective cohort study
title_sort association of statin use and lipid levels with cerebral microbleeds and intracranial hemorrhage in patients with atrial fibrillation: a prospective cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10676039/
https://www.ncbi.nlm.nih.gov/pubmed/37243540
http://dx.doi.org/10.1177/17474930231181010
work_keys_str_mv AT moutzourielisavet associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT glutzmatthias associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT abolhassaninazanin associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT fellermartin associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT adamluise associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT gencerbaris associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT delgiovanecinzia associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT betriseysylvain associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT paladinirebeccae associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT henningselisa associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT aeschbacherstefanie associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT beerjurgh associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT moschovitisgiorgio associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT seiffgedavid associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT demarchisgianmarco associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT coslovskymichael associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT reichlintobias associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT contegiulio associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT sinneckertim associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT schwenkglenksmatthias associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT bonatileoh associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT kastnerpeter associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT aujeskydrahomir associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT kuhnemichael associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT osswaldstefan associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT fischerurs associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT conendavid associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy
AT rodondinicolas associationofstatinuseandlipidlevelswithcerebralmicrobleedsandintracranialhemorrhageinpatientswithatrialfibrillationaprospectivecohortstudy