Risk of hemorrhagic transformation in light acute cerebral ischemic infarction patients with cerebral microbleeds and combined clopidogrel-aspirin treatment

Abstract

Objective To investigate the risk of hemorrhagic transformation (HT) in light acute cerebral ischemic infarction patients with cerebral microbleeds (CMBs) and combined clopidogrel-aspirin treatment. Methods One hundred and twenty-eight patients with light acute cerebral ischemic infarction were selected from January 2015 to January 2017. The patients were divided into non-CMBs group and CMBs group according to the cerebral MRI result; the patients in CMBs group were subdivided into brain lobe subgroup, deep subgroup and mixed subgroup according to the anatomic site of CMBs, and the incidence of HT was compared among the subgroups. Risk factors related to HT in patients with light acute cerebral ischemic infarction were analyzed by Logistic regression. Results The incidence of CMBs was 54.7% (70/128). There was no statistical difference in the incidence of HT between CMBs group and non-CMBs group (P>0.05). In CMBs group, the number of patients with HT in lobe of brain subgroup (13 cases) was 5, in deep subgroup (43 cases) was 5, in mixed subgroup (14 cases) was 3, and there was statistical difference (χ2 = 7.465, P = 0.036). Multifactor Logistic regression analysis result showed that atrial fibrillation (OR = 6.590, 95% CI 2.561 to 17.282, P = 0.000) and fasting blood glucose (OR = 1.132, 95% CI 1.544 to 2.953, P = 0.025) were the independent risk factors of HT in patients with light acute cerebral ischemic infarction. Conclusions The combined clopidogrel-aspirin treatment does not increase the risk of HT in patients with light acute cerebral ischemic infarction combined CMBs, but the combined clopidogrel-aspirin treatment in patients with brain lobe CMBs should be careful. Key words: Brain infarction; Cerebral hemorrhage; Platelet aggregation inhibitors; Retrospective studies; Hemorrhagic transformation