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Role of cerebral microbleeds in acute ischemic stroke and atrial fibrillation

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Abstract

Cerebral microbleeds (CMBs) are commonly detected in the brains of patients with acute ischemic stroke (AIS). With the development of neuroimaging, clinicians are paying more attention to the presence of CMBs. CMBs were found to significantly increase the risk of intracranial hemorrhagic transformation and hemorrhage in patients with AIS, especially in patients with concurrent atrial fibrillation (AF). Additionally, the presence of CMBs is thought to be a symbol of a high risk of recurrent ischemic stroke (IS). A few researchers have found that the presence of CMBs has no significant effect on the prognosis of patients with AIS. Therefore, the current views on the role of CMBs in the prognoses of patients with IS are controversial. The use of anticoagulants and other drugs has also become a dilemma due to the special influence of CMBs on the prognosis of these patients. Due to the large number of patients with AF and CMBs, many studies have been conducted on the effects of CMBs on these patients and subsequent pharmacological treatments. However, at present, there are no relevant guidelines to guide the secondary preventive treatment of patients with stroke, CMBs, and AF. In this paper, we summarized the role of CMBs in AIS combined with AF and relevant preventive measures against the recurrence of stroke and the occurrence of intracerebral hemorrhage to help clarify the specifics of drug therapies for this group of patients.

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Funding

Dr. Xueping Zheng receives grant support from the Affiliated Hospital of Qingdao University (QDFY) grants (X202101032).

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  1. Department of Geriatric Medicine, The Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Qingdao, 266001, Shandong, China

    Meng Wang, Yuyuan Yang, Moxin Luan, Meixiang Zhong, Lulu Xu & Xueping Zheng

  2. Department of Geriatric Medicine, The Qingdao Eighth People’s Hospital, Qingdao, China

    Yajuan Wang

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XZ conceptualized the project. MW and YY performed the literature search and screening. LX and MZ evaluated the quality of the articles. YW and ML extracted and analyzed data from the included literature. WM wrote the manuscript with contribution from XZ. All authors read and approved the final manuscript.

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Wang, M., Yang, Y., Luan, M. et al. Role of cerebral microbleeds in acute ischemic stroke and atrial fibrillation. J Thromb Thrombolysis 55, 553–565 (2023). https://doi.org/10.1007/s11239-022-02761-y

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