Abstract
Cerebral microbleeds (CMBs), which indicate hemorrhage-prone disease, may associate with hemostatic abnormalities, but the association between CMBs and coagulation function is uncertain. We aimed to examine this possible association. The following coagulation function indicators were evaluated in 85 consecutive ischemic stroke patients diagnosed with atrial fibrillation and/or rheumatic heart disease: prothrombintime (PT), activated partial thromboplastin time (APTT), and levels of D-dimer and fibrinogen. Indicators were assessed within 24 h after admission. CMBs were identified based on published criteria by two experienced stroke neurologists working independently. PT, APPT, and levels of D-dimer and fibrinogen were compared between patients with and without CMBs using univariate and multivariate analysis. CMBs were detected in 48 patients (56.5%), and fibrinogen levels in these patients were independently and significantly higher than in patients without CMBs after adjustment (OR 2.16, 95% CI 1.20-3.90, P=0.01), whereas the two types of patients did not differ significantly in PT, APPT, or D-dimer levels. The presence of CMBs in ischemic stroke patients with atrial fibrillation and/or rheumatic heart disease is associated with elevated levels of fibrinogen. Larger prospective studies are needed to verify this association and explore the mechanisms involved.
Highlights
Cerebral microbleeds (CMBs), which indicate hemorrhage-prone disease, may associate with hemostatic abnormalities, but the association between CMBs and coagulation function is uncertain
CMBs occur in many patients with ischemic stroke, and primary intracerebral hemorrhage (ICH); CMBs are associated with elevated risk of spontaneous ICH, and symptomatic ICH after intravenous thrombolysis [68]
Prodan et al [10] found that the presence of CMBs in patients with non-lacunar ischemic stroke is associated with lower levels of coatedplatelets, which are involved in thrombin generation and thereby help drive coagulation [11]
Summary
Cerebral microbleeds (CMBs), which indicate hemorrhage-prone disease, may associate with hemostatic abnormalities, but the association between CMBs and coagulation function is uncertain. The present research was undertaken to compare ischemic stroke patients with and without CMBs in terms of several indicators of coagulation function, including prothrombin time, activated partial thromboplastin time, and levels of D-dimer and fibrinogen.
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