Cerebral Microbleeds, Coumarins: Risk Assessment in the General Population
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Use of antithrombotic drugs, including aspirin and other platelet aggregation inhibitors, has been linked to an increase in cerebral microbleeds; however, it is unclear if coumarin use is associated with cerebral microbleeds in the general population. New research in the journal Stroke assessed data from the population-based Rotterdam study of 3,069 patients aged ≥45 on coumarin use and presence and location of microbleeds that are obtained via brain MRI. Approximately 8% of patients had used coumarins prior to the first MRI and about 6% before follow-up MRI. Microbleed prevalence was 19.4%, with an incidence of 6.9% during a mean follow-up of 3.9 years. Patients taking coumarins had a higher prevalence of deep or infratentorial microbleeds compared to never users; while coumarin users had a higher incidence of any microbleeds, it was not statistically significant. A greater variability in international normalized ratios (INRs) was associated with a higher prevalence of microbleeds among coumarin users as well. Patients taking coumarins should be carefully monitored for cerebral microbleeds, particularly if there are additional risk factors such as hypertension.
Background and Purpose- It remains undetermined whether the use of coumarin anticoagulants associates with cerebral microbleeds in the general population. We investigated whether (1) coumarin use relates to higher prevalence and incidence of microbleeds, (2) microbleeds are more frequent in ...
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