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Interaction of incidental microbleeds and prior use of antithrombotics with early hemorrhagic transformation: Causative or protective?

BACKGROUND: Gradient echo (GRE) sequence of magnetic resonance imaging (MRI) is a sensitive tool to detect hemorrhagic transformation (HT) and old cerebral microbleeds (CMBs). Presence of CMBs and prior use of antithrombotics pose a risk of HT in ischemic stroke. We evaluated the association of CMBs...

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Autores principales: Malhotra, Konark, Khunger, Monica, Ouyang, Bichun, Liebeskind, David S., Mohammad, Yousef M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5144467/
https://www.ncbi.nlm.nih.gov/pubmed/27994355
http://dx.doi.org/10.4103/0972-2327.194423
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author Malhotra, Konark
Khunger, Monica
Ouyang, Bichun
Liebeskind, David S.
Mohammad, Yousef M.
author_facet Malhotra, Konark
Khunger, Monica
Ouyang, Bichun
Liebeskind, David S.
Mohammad, Yousef M.
author_sort Malhotra, Konark
collection PubMed
description BACKGROUND: Gradient echo (GRE) sequence of magnetic resonance imaging (MRI) is a sensitive tool to detect hemorrhagic transformation (HT) and old cerebral microbleeds (CMBs). Presence of CMBs and prior use of antithrombotics pose a risk of HT in ischemic stroke. We evaluated the association of CMBs and antithrombotic use with resultant HT in acute ischemic stroke (AIS). METHODS: This retrospective study included AIS patients admitted to our center between January 2009 and August 2010 who underwent GRE-weighted MRI within 48 h of admission. Demographic and clinical data including diabetes mellitus, hypertension, hyperlipidemia, prior intake of antiplatelets/anticoagulants/statins, and presence of CMBs at admission were collected and compared between patients who developed HT and those who did not. We did a multivariate analysis using logistic regression to assess the effect of CMBs and prior use of antithrombotic agents on the risk of development for early HT in ischemic stroke. RESULTS: Of 529 AIS patients, 81 (15%) were found to have HT during the initial hospital course. CMBs were found in only 9 of 81 patients (11%) with HT and in 40 out of remaining 448 patients (9%) who did not develop HT. The presence of CMBs was not associated with increased risk of HT (P = 0.53). However, prior use of antiplatelets (33% vs. 47% in the patients without HT, P = 0.02) was associated with decreased risk of HT in ischemic stroke. CONCLUSION: Presence of incidental CMBs was not associated with increased risk for early HT of an ischemic stroke. Interestingly, the prior intake of antiplatelets was found to be protective against HT of ischemic stroke.
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spelling pubmed-51444672016-12-19 Interaction of incidental microbleeds and prior use of antithrombotics with early hemorrhagic transformation: Causative or protective? Malhotra, Konark Khunger, Monica Ouyang, Bichun Liebeskind, David S. Mohammad, Yousef M. Ann Indian Acad Neurol Original Article BACKGROUND: Gradient echo (GRE) sequence of magnetic resonance imaging (MRI) is a sensitive tool to detect hemorrhagic transformation (HT) and old cerebral microbleeds (CMBs). Presence of CMBs and prior use of antithrombotics pose a risk of HT in ischemic stroke. We evaluated the association of CMBs and antithrombotic use with resultant HT in acute ischemic stroke (AIS). METHODS: This retrospective study included AIS patients admitted to our center between January 2009 and August 2010 who underwent GRE-weighted MRI within 48 h of admission. Demographic and clinical data including diabetes mellitus, hypertension, hyperlipidemia, prior intake of antiplatelets/anticoagulants/statins, and presence of CMBs at admission were collected and compared between patients who developed HT and those who did not. We did a multivariate analysis using logistic regression to assess the effect of CMBs and prior use of antithrombotic agents on the risk of development for early HT in ischemic stroke. RESULTS: Of 529 AIS patients, 81 (15%) were found to have HT during the initial hospital course. CMBs were found in only 9 of 81 patients (11%) with HT and in 40 out of remaining 448 patients (9%) who did not develop HT. The presence of CMBs was not associated with increased risk of HT (P = 0.53). However, prior use of antiplatelets (33% vs. 47% in the patients without HT, P = 0.02) was associated with decreased risk of HT in ischemic stroke. CONCLUSION: Presence of incidental CMBs was not associated with increased risk for early HT of an ischemic stroke. Interestingly, the prior intake of antiplatelets was found to be protective against HT of ischemic stroke. Medknow Publications & Media Pvt Ltd 2016 /pmc/articles/PMC5144467/ /pubmed/27994355 http://dx.doi.org/10.4103/0972-2327.194423 Text en Copyright: © Annals of Indian Academy of Neurology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Malhotra, Konark
Khunger, Monica
Ouyang, Bichun
Liebeskind, David S.
Mohammad, Yousef M.
Interaction of incidental microbleeds and prior use of antithrombotics with early hemorrhagic transformation: Causative or protective?
title Interaction of incidental microbleeds and prior use of antithrombotics with early hemorrhagic transformation: Causative or protective?
title_full Interaction of incidental microbleeds and prior use of antithrombotics with early hemorrhagic transformation: Causative or protective?
title_fullStr Interaction of incidental microbleeds and prior use of antithrombotics with early hemorrhagic transformation: Causative or protective?
title_full_unstemmed Interaction of incidental microbleeds and prior use of antithrombotics with early hemorrhagic transformation: Causative or protective?
title_short Interaction of incidental microbleeds and prior use of antithrombotics with early hemorrhagic transformation: Causative or protective?
title_sort interaction of incidental microbleeds and prior use of antithrombotics with early hemorrhagic transformation: causative or protective?
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5144467/
https://www.ncbi.nlm.nih.gov/pubmed/27994355
http://dx.doi.org/10.4103/0972-2327.194423
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