Key result
The presence of cerebral microbleeds was independently associated with the incidence of warfarin-related intracerebral hemorrhage (adjusted OR 83.12).
Why the study?
Are cerebral microbleeds associated with an increased risk of warfarin-related intracerebral hemorrhage in patients on outpatient warfarin therapy?
Case-Control (n=72)
Are cerebral microbleeds associated with an increased risk of warfarin-related intracerebral hemorrhage in patients on outpatient warfarin therapy?
Effect estimate: adjusted OR 83.12
Absolute Event Rate: 79.2% vs 22.9%
p-value: p=<0.001
The presence of cerebral microbleeds is strongly associated with an increased risk of warfarin-related intracerebral hemorrhage, suggesting a need to carefully weigh risks and benefits of anticoagulation in these patients.
Cerebral microbleeds may signal high warfarin ICH risk; leaves open whether screening should alter anticoagulation decisions.
BACKGROUND: Cerebral microbleeds are known to be indicative of bleeding-prone microangiopathy and may predict incident intracerebral hemorrhage (ICH). In this study, we investigated whether microbleeds are associated with the incidence of warfarin-related ICH. METHODS: Twenty-four patients with ICH while on outpatient treatment with warfarin were selected from a consecutive cohort. Control, warfarin-using subjects with no history of ICH were randomly selected during the same time period (n = 48). We compared demographic factors, vascular risk factors, laboratory findings, and radiologic findings including microbleeds between the groups. RESULT: There were more cases of patients with microbleeds in the ICH than control group (79.2% vs 22.9%: p < 0.001), and the number of microbleeds was much higher for the ICH group (9.0 +/- 26.8 vs 0.5 +/- 1.03: p < 0.001). Moreover, the number of microbleeds was significantly correlated with the presence of warfarin-related ICH (r = 0.299; p < 0.001). Conditional logistic regression analysis showed that increased prothrombin time and the presence of microbleeds were independently related to the incidence of warfarin-related ICH (microbleeds: adjusted OR, 83.12). CONCLUSION: This study suggests that underlying microbleeds are independently associated with an incidence of warfarin-related intracerebral hemorrhage. Future research should focus on elucidating the risks and benefits of warfarin medication in patients with microbleeds.
No takes yet. Share an insight, caveat, or question.
Lee et al. (2009) conducted a case-control in Warfarin-related intracerebral hemorrhage (n=72). Cerebral microbleeds vs. No cerebral microbleeds was evaluated on Presence of cerebral microbleeds in ICH cases versus controls (adjusted OR 83.12, p=<0.001). The presence of cerebral microbleeds was independently associated with the incidence of warfarin-related intracerebral hemorrhage (adjusted OR 83.12).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: