Study Of Cerebral Microbleeds After Antiplatelet Therapy In Mongolian Patients With Ischemic Cerebrovascular Disease

Objective:To analyze the differences in cerebral microbleeds(CMBs)and their association with white matter hyperintensities(WMHs)and intracerebral hemorrhage(ICH)in Mongolian and Han Chinese patients with ischemic cerebrovascular disease after antiplatelet drug therapy.Materials and methods:Retrospective analysis of 160 patients with ischemic cerebrovascular disease who took aspirin(100 mg/day)or clopidogrel(75 mg/day)for more than 1 year(January 2020 to December 2021),divided into 80 cases each of Mongolian and Han Chinese according to ethnicity.All patients received T2-weighted imaging(T2WI),T1-weighted imaging(T1WI),diffusion-weighted imaging(DWI),and magnetic susceptibility-weighted imaging(SWI)(Siemens Healthcare,Germany),and the grade and distribution of CMBs and WMHs were independently evaluated by experienced imaging physicians on a blinded basis.Clinical information and relevant vascular risk factors of the patients were also recorded,including their age,gender,presence of hypertension,diabetes,hyperlipidemia,history of smoking and alcohol consumption,and the patients’dose of antiplatelet drugs,duration of administration,and whether ICH occurred after administration need to be specifically documented.To analyze the differences in the detection rate,severity and anatomical distribution of CMBs after antiplatelet therapy in Mongolian and Han Chinese patients with ischemic cerebrovascular disease,and to explore the relationship between CMBs,WMHs and ICH and the effect of different medication duration on CMBs and ICH using multivariate logistic regression analysis.Results:CMBs detection rate in Mongolian patients with ischemic cerebrovascular disease is lower than in Han Chinese patients after treatment with oral antiplatelet drugs(42.5%vs 58.8%;χ~2=4.226;P=0.040),while the severity of CMBs was not significantly different between them(P>0.05).Mongolian patients had more CMBs distributed in the deep or infratentorial region than Han Chinese(66.6%vs 58.1%),while fewer CMBs were located in the lobar region(33.4%vs 41.9%;χ~2=7.159;P=0.007).WMHs were correlated with CMBs for both Mongolian and Han patients(Mongolian:OR=3.60;95%CI:1.06～12.29;P=0.041 Han Chinese:OR=5.26;95%CI:1.27～21.70;P=0.022),and long-term(>3 years)antiplatelet medication was significantly associated with both CMBs(Mongolian:OR=5.10;95%CI:1.39～18.65;P=0.014 Han Chinese:OR=3.62;95%CI:1.33～9.87;P=0.012)and ICH(Mongolian:OR=4.13;95%CI:1.06～16.17;P=0.042 Han Chinese:OR=3.17;95%CI:1.08～9.27;P=0.035),and this association persisted after adjusting for cerebrovascular disease confounders.Conclusion:(1)The detection rate of CMBs was lower in Mongolian patients with ischemic cerebrovascular disease after antiplatelet drug treatment than in Han Chinese patients.(2)Mongolian patients had more distribution of CMBs in deep or infratentorial region than Han Chinese,while fewer CMBs in lobar region than Han Chinese.(3)The presence of CMBs was associated with an increased risk of ICH,especially in Mongolian versus Han patients on long-term antiplatelet medication,and WMHs were also an independent risk factor associated with CMBs.