Annals of Indian Academy of Neurology
ORIGINAL ARTICLE
Year
: 2016  |  Volume : 19  |  Issue : 4  |  Page : 467--471

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


Konark Malhotra1, Monica Khunger2, Bichun Ouyang3, David S Liebeskind1, Yousef M Mohammad4 
1 Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
2 Cleveland Clinic Foundation, Cleveland, OH, USA
3 Department of Neurology, RUSH University Medical Center, Chicago, IL, USA
4 Department of Internal Medicine, King Saud University, Riyadh, Saudi Arabia

Correspondence Address:
Konark Malhotra
757 Westwood Plaza, Los Angeles, CA 90095
USA

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.


How to cite this article:
Malhotra K, Khunger M, Ouyang B, Liebeskind DS, Mohammad YM. Interaction of incidental microbleeds and prior use of antithrombotics with early hemorrhagic transformation: Causative or protective?.Ann Indian Acad Neurol 2016;19:467-471


How to cite this URL:
Malhotra K, Khunger M, Ouyang B, Liebeskind DS, Mohammad YM. Interaction of incidental microbleeds and prior use of antithrombotics with early hemorrhagic transformation: Causative or protective?. Ann Indian Acad Neurol [serial online] 2016 [cited 2022 Aug 16 ];19:467-471
Available from: https://www.annalsofian.org/article.asp?issn=0972-2327;year=2016;volume=19;issue=4;spage=467;epage=471;aulast=Malhotra;type=0