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dc.contributor.authorSoo, Yannie
dc.contributor.authorZietz, Annaelle
dc.contributor.authorYiu, Brian
dc.contributor.authorMok, Vincent C. T.
dc.contributor.authorPolymeris, Alexandros A.
dc.contributor.authorSeiffge, David
dc.contributor.authorAmbler, Gareth
dc.contributor.authorWilson, Duncan
dc.contributor.authorLeung, Thomas Wai Hong
dc.contributor.authorTsang, Suk Fung
dc.contributor.authorChu, Winnie
dc.contributor.authorAbrigo, Jill
dc.contributor.authorOrken, Dilek Necioglu
dc.date.accessioned2023-06-05T11:59:52Z
dc.date.available2023-06-05T11:59:52Z
dc.date.issued2023en_US
dc.identifier.citationSoo, Y., Zietz, A., Yiu, B., Mok, V. C., Polymeris, A. A., Seiffge, D., ... & Microbleeds International Collaborative Network. (2023). Impact of Cerebral Microbleeds in Stroke Patients with Atrial Fibrillation. Annals of neurology.en_US
dc.identifier.issn0364-5134
dc.identifier.urihttps://doi.org/10.1002/ana.26642
dc.identifier.urihttps://hdl.handle.net/20.500.12294/3895
dc.description.abstractObjectives: Cerebral microbleeds are associated with the risks of ischemic stroke and intracranial hemorrhage, causing clinical dilemmas for antithrombotic treatment decisions. We aimed to evaluate the risks of intracranial hemorrhage and ischemic stroke associated with microbleeds in patients with atrial fibrillation treated with vitamin K antagonists, direct oral anticoagulants, antiplatelets, and combination therapy (i.e. concurrent oral anticoagulant and antiplatelet). Methods: We included patients with documented atrial fibrillation from the pooled individual patient data analysis by the Microbleeds International Collaborative Network. Risks of subsequent intracranial hemorrhage and ischemic stroke were compared between patients with and without microbleeds, stratified by antithrombotic use. Results: A total of 7,839 patients were included. The presence of microbleeds was associated with an increased relative risk of intracranial hemorrhage (adjusted hazard ratio [aHR] = 2.74, 95% confidence interval = 1.76–4.26) and ischemic stroke (aHR = 1.29, 95% confidence interval = 1.04–1.59). For the entire cohort, the absolute incidence of ischemic stroke was higher than intracranial hemorrhage regardless of microbleed burden. However, for the subgroup of patients taking combination of anticoagulant and antiplatelet therapy, the absolute risk of intracranial hemorrhage exceeded that of ischemic stroke in those with 2 to 4 microbleeds (25 vs 12 per 1,000 patient-years) and ≥ 11 microbleeds (94 vs 48 per 1,000 patient-years). Interpretation: Patients with atrial fibrillation and high burden of microbleeds receiving combination therapy have a tendency of higher rate of intracranial hemorrhage than ischemic stroke, with potential for net harm. Further studies are needed to help optimize stroke preventive strategies in this high-risk group. ANN NEUROL 2023. © 2023 The Authors. Annals of Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.en_US
dc.language.isoengen_US
dc.publisherJohn Wiley and Sons Incen_US
dc.relation.ispartofAnnals of Neurologyen_US
dc.identifier.doi10.1002/ana.26642en_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.titleImpact of Cerebral Microbleeds in Stroke Patients with Atrial Fibrillationen_US
dc.typearticleen_US
dc.departmentTıp Fakültesi, Temel Tıp Bilimleri Bölümüen_US
dc.authorid0000-0002-1118-5309en_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.institutionauthorOrken, Dilek Necioglu
dc.authorscopusid25923056600en_US
dc.identifier.scopus2-s2.0-85153280437en_US


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