Correlation of Non-vitamin K Antagonist Oral Anticoagulant Exposure and Cerebral Microbleeds in Chinese Patients With Atrial Fibrillation
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AbstractBackground - 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 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. AF patients 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 (i.e. age, hypertension, labile hypertension, stroke history and white matter scores), previous ICH 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.

Conclusion - 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.
All Author(s) ListYannie Soo, Jill Abrigo, Kam Tat Leung, Wenyan Liu, Bonnie Lam, Suk Fung Tsang, Vincent Ip, Karen Ma, Bonaventure Ip, Sze Ho Ma, Florence Fan, Winnie Chu, Lawrence Wong, Vincent Mok, Thomas Leung
Journal nameJournal of Neurology, Neurosurgery and Psychiatry
Year2018
Month7
Volume Number89
Issue Number7
PublisherBMJ Publishing Group
Pages680 - 686
ISSN0022-3050
eISSN1468-330X
LanguagesEnglish-United Kingdom
KeywordsNOAC, cerebral microbleeds, Chinese and atrial fibrillation

Last updated on 2021-21-09 at 00:12