Introduction: The relationship between treatment with antithrombotic agents and the presence of cerebral microbleeds[CMBs] remains unclear. We investigated the relationship between the type of past treatment with antithrombotic agents and the presence of CMBs in acute ischemic stroke patients.
Methods: A total of 493 acute ischemic stroke patients (mean age 71; 60% male) who had undergone 1.5T gradient-echo T2*-weighted MR imaging after acute ischemic stroke onset were enrolled. The patients were classified into 6 groups according to the type of past treatment with antithrombotic agents: 337 patients with no antithrombotic agent, 58 patients treated with aspirin only, 33 patients with a single antiplatelet agent other than aspirin, 34 patients with aspirin and other antithrombotic agents, 5 patients with antiplatelet agent other than aspirin and other antithrombotic agents and 26 patients with anticoagulant only. The associations between the type of antithrombotic agents and the presence of CMBs were studied using a logistic regression analysis.
Results: A total of 173(35%) of 493 had CMBs. Of theses, 35(7%) had strictly lobar CMBs and 138(28%) had deep or infratentorial CMBs. The presence of CMBs were significantly associated with age (P<0.001), history of stroke (P<0.001), chronic kidney disease (P<0.001), low LDL-cholesterol (P=0.027), aspirin only (P=0.0006), and aspirin and other antithrombotic agents (P=0.009), but were not associated with antithrombotic agents other than aspirin. The multivariate analysis revealed that aspirin was associated with the presence of CMBs (aspirin: odds ratio 1.99; 95% confidence interval, 1.06-3.74; compared with reference group of no antithrombotic agent), after adjustment for confounders.
Conclusions: It seems that past treatment with aspirin is associated with the presence of CMBs in acute ischemic stroke patients.