Prevalence and Risk Factors of Cerebral Microbleeds among Egyptian Patients with Acute Ischemic Stroke.

IF 3.2 3区医学 Q2 CLINICAL NEUROLOGY Neuroepidemiology Pub Date : 2024-07-17 DOI:10.1159/000540296

Ahmed Nasreldein, Ashkan Shoamnesh, Nageh Foli, Marwa Makboul, Sabreen Salah, Klaus Faßbender, Silke Walter

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Abstract

Background: Cerebral microbleeds (CMBs) are markers of underlying hemorrhage-prone cerebral small vessel disease detected on MRI. They are associated with a heightened risk of stroke and cognitive decline. The prevalence of CMBs among Egyptian patients with ischemic stroke is not well studied. Our aim was to detect the prevalence of CMBs and associated risk factors among Egyptian patients with ischemic stroke.

Methods: A prospective, cross-sectional, single-center study of consecutive patients with ischemic stroke. Patients were recruited between January 2021 and January 2022 at the Assiut University Hospital in the south of Egypt. Patients with known bleeding diathesis were excluded. All participants underwent full neurological assessment, urgent laboratory investigations, and MRI with T2* sequence.

Results: The study included 404 patients, 191 (47.3%) of them were females. The mean age of the study population was 61 ± 1 years, and the mean NIHSS on admission was 12 ± 5. The prevalence of CMB was 26.5%, of whom 6.5% were young adults (age ≤45 years). CMBs were detected in 34.6% of patients with stroke caused by large artery atherosclerosis, 28.0% with small vessel disease stroke subtype, 25.2% with stroke of undetermined cause, and in 12.1% with cardioembolic stroke. History of AF, hypertension, dyslipidemia, Fazekas score >2, dual antiplatelet use, combined antiplatelet with anticoagulant treatment, and thrombolytic therapy remained independently associated with CMBs following multivariable regression analyses.

Conclusion: The high number of identified CMBs needs to inform subsequent therapeutic management of these patients. We are unable to determine whether the association between CMBs and antithrombotic use is a causal relationship or rather confounded by indication for these treatments in our observational study. To understand more about the underlying cause of this finding, more studies are needed.

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埃及急性缺血性中风患者脑微小出血的患病率和风险因素。

背景：脑微出血（CMBs）是磁共振成像中发现的潜在易出血脑小血管疾病的标志物。它们与中风和认知能力下降的风险增加有关。关于埃及缺血性中风患者中 CMBs 的患病率，目前还没有很好的研究。我们的目的是检测埃及缺血性中风患者中 CMB 的患病率及相关风险因素：方法：对连续的缺血性中风患者进行前瞻性、横断面、单中心研究。患者于 2021 年 1 月至 2022 年 1 月期间在埃及南部的阿西奎特大学医院招募。已知有出血症状的患者被排除在外。所有参与者均接受了全面的神经系统评估、紧急实验室检查和T2*序列磁共振成像检查：研究共纳入 404 名患者，其中 191 名（47.3%）为女性。研究对象的平均年龄为 61±1 岁，入院时的 NIHSS 平均值为 12±5。CMB发病率为26.5%，其中6.5%为年轻人（年龄小于45岁）。34.6%的大动脉粥样硬化引起的中风患者、28.0%的小血管疾病中风亚型患者、25.2%的不明原因中风患者和12.1%的心源性栓塞性中风患者发现了CMB。经多变量回归分析，房颤史、高血压、血脂异常、法泽卡斯评分（Fazekas score > 2）、使用双联抗血小板药物、联合抗血小板与抗凝治疗以及溶栓治疗仍与 CMBs 独立相关：结论：已发现的大量 CMBs 需要为这些患者的后续治疗管理提供依据。在我们的观察性研究中，我们无法确定 CMB 与抗血栓药物使用之间的关系是因果关系还是受适应症的影响。要进一步了解这一发现的根本原因，还需要更多的研究。

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来源期刊

Neuroepidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

9.90

自引率

1.80%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Neuroepidemiology'' is the only internationally recognised peer-reviewed periodical devoted to descriptive, analytical and experimental studies in the epidemiology of neurologic disease. The scope of the journal expands the boundaries of traditional clinical neurology by providing new insights regarding the etiology, determinants, distribution, management and prevention of diseases of the nervous system.