Key result
In 282 Chinese patients with atrial fibrillation, neither exposure to nor duration of NOAC therapy was predictive of the presence of cerebral microbleeds, which were observed in 36.5% of patients.
Why the study?
Does NOAC exposure correlate with the prevalence of cerebral microbleeds in Chinese patients with atrial fibrillation?
Cross-Sectional (n=282)
Does NOAC exposure correlate with the prevalence of cerebral microbleeds in Chinese patients with atrial fibrillation?
In Chinese patients with atrial fibrillation, NOAC exposure and duration do not appear to correlate with the prevalence or burden of cerebral microbleeds.
NOAC exposure was not associated with CMB prevalence or burden in AF; leaves open whether CMBs should guide anticoagulation decisions.
BACKGROUND AND PURPOSE: Cerebral microbleeds (CMBs) are radiological markers which predict future intracerebral haemorrhage. Researchers are exploring how CMBs can guide anticoagulation decisions in atrial fibrillation (AF). The purpose of this study is to evaluate the correlation of non-vitamin K antagonist oral anticoagulants (NOAC) exposure and prevalence of CMBs in Chinese patients with AF. METHODS: We prospectively recruited Chinese patients with AF on NOAC therapy of ≥30 days for 3T MRI brain for evaluation of CMBs and white matter hyperintensities. Patients with AF without prior exposure to oral anticoagulation were recruited as control group. RESULTS: A total of 282 patients were recruited, including 124 patients in NOAC group and 158 patients in control group. Mean duration of NOAC exposure was 723.8±500.3 days. CMBs were observed in 103 (36.5%) patients. No significant correlation was observed between duration of NOAC exposure and quantity of CMBs. After adjusting for confounding factors (ie, age, hypertension, labile hypertension, stroke history and white matter scores), previous intracerebral haemorrhage was predictive of CMBs (OR 15.28, 95% CI 1.81 to 129.16), particularly lobar CMBs (OR 5.37, 95% CI 1.27 to 22.6). While white matter score was predictive of mixed lobar CMBs (OR 1.65, 95% CI 1.1 to 2.5), both exposure and duration of NOAC use were not predictive of presence of CMBs. CONCLUSIONS: In Chinese patients with AF, duration of NOAC exposure did not correlate with prevalence and burden of CMBs. Further studies with follow-up MRI are needed to determine if long-term NOAC therapy can lead to development of new CMBs.
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Soo et al. (2018) conducted a cross-sectional in Atrial fibrillation (n=282). Non-vitamin K antagonist oral anticoagulants (NOAC) vs. No prior exposure to oral anticoagulation was evaluated on Presence of cerebral microbleeds (CMBs). In 282 Chinese patients with atrial fibrillation, neither exposure to nor duration of NOAC therapy was predictive of the presence of cerebral microbleeds, which were observed in 36.5% of patients.
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