Abstract P014: Poor Blood Pressure Control and Severe Coronary Artery Lesions Are Risks of Cerebral Microbleeds in Patients With Coronary Artery Disease During Antiplatelet Therapy

Abstract

Background and Purpose: Brain hemorrhage is a serious complication of antiplatelet therapy, particularly dual antiplatelet therapy (DAPT), in patients with coronary artery disease (CAD) who undergo percutaneous coronary intervention (PCI). Cerebral microbleeds (CMBs) detected on MRI is a surrogate of symptomatic brain hemorrhage. However, little is known regarding CMBs in CAD patients during long-term antiplatelet therapy. Therefore, we investigated the temporal change of CMBs during antiplatelet therapy in CAD patients after PCI. Method: Brain MRI was performed at baseline and after 8-month follow-up in consecutive 14 patients who underwent PCI and antiplatelet therapy (DAPT in 13 patients). Results: Baseline MRI revealed CMBs in 2 patients (14%). New CMBs were detected by follow-up MRI in 2 other patients (14%). Although blood pressure (BP) at baseline did not differ between the CMB-positive and CMB-negative patients, BP after 8 months was significantly higher in CMB-positive patients than CMB-negative ones (systolic BP: p=0.03, diastolic BP: p=0.02). Moreover, CMB-positive patients had greater number of coronary artery lesions and higher SYNTAX score at baseline than CMB-negative patients (Figure). Conclusions: CAD patients with poor BP control and severe coronary artery lesions would be at higher risk for CMBs and eventually brain hemorrhage during antiplatelet therapy. Accordingly, strict coronary risk control, especially BP control, is necessary in CAD patients receiving long-term antiplatelet therapy.