Publication:
Stroke Risk and Antithrombotic Treatment During Follow-up of Patients With Ischemic Stroke and Cortical Superficial Siderosis.

cris.virtual.author-orcid0000-0001-5800-116X
cris.virtualsource.author-orcida23d3049-bb4e-4895-99fe-55e4de9f41b1
cris.virtualsource.author-orcid268c6868-3f45-4f65-b1ab-8eee3e23d854
cris.virtualsource.author-orcidf3e66f7a-0491-4feb-9de2-e9558a65560c
cris.virtualsource.author-orcid1963851a-c2fa-4878-b4e1-48d9aabed5ea
datacite.rightsopen.access
dc.contributor.authorMartí-Fàbregas, Joan
dc.contributor.authorCamps-Renom, Pol
dc.contributor.authorBest, Jonathan G
dc.contributor.authorRamos-Pachon, Anna
dc.contributor.authorGuasch-Jiménez, Marina
dc.contributor.authorMartinez-Domeño, Alejandro
dc.contributor.authorGuisado-Alonso, Daniel
dc.contributor.authorGómez-Ansón, Beatriz M
dc.contributor.authorAmbler, Gareth
dc.contributor.authorWilson, Duncan
dc.contributor.authorLee, Keon-Joo
dc.contributor.authorLim, Jae-Sung
dc.contributor.authorBae, Hee-Joon
dc.contributor.authorShiozawa, Masayuki
dc.contributor.authorKoga, Masatoshi
dc.contributor.authorToyoda, Kazunori
dc.contributor.authorHennerici, Michael G
dc.contributor.authorChabriat, Hugues
dc.contributor.authorJouvent, Eric
dc.contributor.authorKwun Wong, Debbie Yuen
dc.contributor.authorMak, Henry
dc.contributor.authorLau, Kui Kai
dc.contributor.authorKim, Young Dae
dc.contributor.authorSong, Tae-Jin
dc.contributor.authorHeo, Ji-Hoe
dc.contributor.authorEppinger, Sebastian
dc.contributor.authorGattringer, Thomas
dc.contributor.authorUysal, Ender
dc.contributor.authorDemirelli, Derya Selçuk
dc.contributor.authorBornstein, Natan
dc.contributor.authorBen Assayag, Einor
dc.contributor.authorHallevi, Hen
dc.contributor.authorMolad, Jeremy A
dc.contributor.authorNishihara, Masashi
dc.contributor.authorTanaka, Jun
dc.contributor.authorHara, Hideo
dc.contributor.authorYakushiji, Yusuke
dc.contributor.authorCoutts, Shelagh B
dc.contributor.authorSmith, Eric
dc.contributor.authorPolymeris, Alexandros A
dc.contributor.authorWagner, Benjamin
dc.contributor.authorSeiffge, David Julian
dc.contributor.authorLyrer, Philippe A
dc.contributor.authorPeters, Nils
dc.contributor.authorEngelter, Stefan T
dc.contributor.authorAl-Shahi Salman, Rustam
dc.contributor.authorJäger, Hans Rudolf
dc.contributor.authorLip, Gregory Y H
dc.contributor.authorGöldlin, Martina Béatrice
dc.contributor.authorPanos, Leonidas
dc.contributor.authorKarayiannis, Christopher Charles
dc.contributor.authorPhan, Thanh G
dc.contributor.authorSrikanth, Velandai K
dc.contributor.authorChrist, Nicolas
dc.contributor.authorGunkel, Sarah
dc.contributor.authorFluri, Felix
dc.contributor.authorLeung, Thomas W
dc.contributor.authorSoo, Yannie O Y
dc.contributor.authorChu, Winnie
dc.contributor.authorAbrigo, Jill
dc.contributor.authorBarbato, Carmen
dc.contributor.authorBrowning, Simone
dc.contributor.authorSimister, Robert
dc.contributor.authorMendyk, Anne-Marie
dc.contributor.authorBordet, Régis
dc.contributor.authorHilal, Saima
dc.contributor.authorGyanwali, Bibek
dc.contributor.authorChen, Christopher
dc.contributor.authorJung, Simon
dc.contributor.authorOrken, Dilek Necioglu
dc.contributor.authorWerring, David
dc.contributor.authorPrats-Sanchez, Luis
dc.date.accessioned2024-10-14T22:50:10Z
dc.date.available2024-10-14T22:50:10Z
dc.date.issued2023-03-21
dc.description.abstractBACKGROUND AND OBJECTIVES In patients with ischemic stroke (IS) or TIA and cortical superficial siderosis (cSS), there are few data regarding the risk of future cerebrovascular events and also about the benefits and safety of antithrombotic drugs for secondary prevention. We investigated the associations of cSS and stroke risk in patients with recent IS or TIA. METHODS We retrospectively analyzed the Microbleeds International Collaborative Network (MICON) database. We selected patients with IS or TIA from cohorts who had MRI-assessed cSS, available data on antithrombotic treatments, recurrent cerebrovascular events [Intracranial hemorrhage -ICrH-, IS, or any stroke (ICrH or IS)], and mortality. We calculated incidence rates (IR) and performed univariable and multivariable Cox regression analyses. RESULTS Of 12.669 patients (mean age 70.4±12.3 years, 57.3% men), cSS was detected in 273 (2.2%) patients. During a mean follow-up of 24±17 months, IS was more frequent than ICrH in both cSS (IR 57.1 versus 14.6 per 1000 patient-years) and non-cSS groups (33.7 versus 6.3 per 1000 patient years). Compared to the non-CSS group, cSS was associated with any stroke on multivariable analysis [IR 83 versus 42 per 1000 patient-years, adjusted HR for cSS 1.62 (95%CI: 1.14-2.28; p=0.006)]. This association was not significant in subgroups of patients treated with antiplatelet drugs (n=6.554) or with anticoagulants (n=4.044). Patients with cSS who were treated with both antiplatelet drugs and anticoagulants (n=1.569) had a higher incidence of ICrH (IR 107.5 vs 4.9 per 1000 patient-years, adjusted HR 13.26; 95%CI: 2.90-60.63; p=0.001) and of any stroke (IR 198.8 vs 34.7 per 1000 patient-years, adjusted HR 5.03; 95%CI: 2.03-12.44; p<0.001) compared to the non-CSS group. DISCUSSION Patients with IS or TIA with cSS are at increased risk of stroke (ICrH or IS) during follow-up; the risk of IS exceeds that of ICrH for patients receiving antiplatelet or anticoagulant treatment alone, but the risk of ICrH exceeds that of IS in patients receiving both treatments. The findings suggest that either antiplatelet or anticoagulant treatment alone should not be avoided in patients with cSS, but combined antithrombotic therapy might be hazardous. Our findings need to be confirmed by randomized clinical trials.
dc.description.sponsorshipUniversitätsklinik für Neurologie
dc.identifier.doi10.48350/176159
dc.identifier.pmid36535778
dc.identifier.publisherDOI10.1212/WNL.0000000000201723
dc.identifier.urihttps://boris-portal.unibe.ch/handle/20.500.12422/116363
dc.language.isoen
dc.publisherAmerican Academy of Neurology
dc.relation.ispartofNeurology
dc.relation.issn1526-632X
dc.relation.organizationDCD5A442BAE0E17DE0405C82790C4DE2
dc.subject.ddc600 - Technology::610 - Medicine & health
dc.titleStroke Risk and Antithrombotic Treatment During Follow-up of Patients With Ischemic Stroke and Cortical Superficial Siderosis.
dc.typearticle
dspace.entity.typePublication
dspace.file.typetext
oaire.citation.endPagee1281
oaire.citation.issue12
oaire.citation.startPagee1267
oaire.citation.volume100
oairecerif.author.affiliationUniversitätsklinik für Neurologie
oairecerif.author.affiliationUniversitätsklinik für Neurologie
oairecerif.author.affiliationUniversitätsklinik für Neurologie
oairecerif.author.affiliationUniversitätsklinik für Neurologie
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unibe.date.embargoChanged2023-12-19 23:25:04
unibe.date.licenseChanged2022-12-22 03:02:24
unibe.description.ispublishedpub
unibe.eprints.legacyId176159
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unibe.subtype.articlejournal

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