Ischemic Stroke
Conditions
Keywords
Cerebral Hemorrhage, anti-thrombosis
Brief summary
The purpose of this prospective cohort study is to investigate whether antithrombotic therapy in the secondary prevention of ischemic stroke increases the risk of the emerging CMBs and whether the change is associated with an increased risk of intracranial hemorrhage, providing an imaging evidence for individualized antithrombotic therapy in such patients.
Detailed description
Cerebral microbleeds（CMBs） is a subclinical lesion caused by microvascular disease in the brain, characterized by microleakage of blood. About 30% of ischemic stroke patients, 40% of the healthy people over 80 years old, and 60% of intracranial hemorrhage patients have microbleeds. With the development of imaging technology, clinically more and more patients have found microbleeds in the brain. How these patients are treated with antithrombotic drugs is not yet clear and is in urgent need of evidence. There are only a few prospective cohort studies to determine whether antithrombotic therapy increases the risk of intracranial hemorrhage in ischemic stroke patients with CMBs, but the results are uncertain. More importantly, whether antithrombotic therapy increases the incidence of the emerging CMBs, and whether the change of increased microbleeds is associated with increased intracranial hemorrhage has not been reported.
Interventions
OTHERSWI sequence
Acute ischemic stroke patient confirmed by SWI sequence
Sponsors
General Hospital of Shenyang Military Region
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Patient age ≥18 years; 2. Acute ischemic stroke patient confirmed by imaging; 3. Time of onset: within 3 months; 4. Baseline SWI sequence is completed before starting the secondary prevention of ischemic stroke; 5. Baseline SWI sequence must have at least one CMB ; 6. NIHSS≤10
Exclusion criteria
1. MRI contraindication; 2. Hemorrhagic transformation after acute Ischemic stroke; 3. Contraindication for antiplatelet or anticoagulation therapy; 4. Severe head trauma or intracranial hemorrhage occurred in the past six months; 5. obvious coagulopathy; 6. Other intracranial lesions associated with (such as tumor, cerebral vascular malformation); 7. other unqualified patients judged by the investigator
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| all cerebral bleeding events | 360 days | incidence of both cerebral microbleeds and intracranial hemorrhage, determined by MRI |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| all cerebral bleeding events | 180 days | incidence of both cerebral microbleeds and intracranial hemorrhage, determined by MRI |
| proportion of mRS 0-1. | 180、360 days | the minimum and maximum values of modified Rankin Score (mRS) are 0 and 6, respectively; higher score mean a worse outcome |
| proportion of cerebral microbleeds | 180 、360 days | cerebral microbleeds, determined by MRI |
| proportion of cerebral hemorrhage | 180、360 days | cerebral hemorrhage, determined by MRI |
| the occurence of stroke or other vascular events | 180、360 days | — |
| the occurence of death due to any cause | 180、360 days | — |
Countries
China
Contacts
CONTACTchen huisheng, doctor
CONTACTwang xinhong, doctor
STUDY_DIRECTORchen huisheng, doctor
General Hospital of Shenyang Military Region
Outcome results
None listed