Cerebral microbleeds predict adverse cardiac, cerebrovascular events in CAD patients

The presence of cerebral microbleeds is associated with major adverse cardiac and cerebrovascular events in patients with coronary artery disease (CAD) on antithrombotic treatment, a study has found.

This study aimed to determine the clinical effect of the presence of cerebral microbleeds in a total of 447 CAD patients receiving at least one thrombotic agent who underwent brain magnetic resonance imaging. The investigators then examined the association between the presence of cerebral microbleeds and the incidence of major adverse cardiac and cerebrovascular events.

Of the patients, 18.7 percent were identified to have cerebral microbleeds over a median follow-up duration of 1,055 days (interquartile range, 781–1,172). In Kaplan–Meier survival analysis, patients with cerebral microbleeds were more likely to experience major adverse cardiac and cerebrovascular events than those without (log-rank p=0.003).

Multivariate Cox regression analysis revealed the independent association of the presence of cerebral microbleeds with the occurrence of major adverse cardiac and cerebrovascular events after adjusting for other classical risk factors for coronary artery disease (hazard ratio, 1.965, 95 percent confidence interval, 1.086–3.556; p=0.026).

In addition, hypertension correlated with the presence of cerebral microbleeds. The cutoff values to maximize the predictive power of systolic and diastolic blood pressure were 132 and 74 mm Hg, respectively (p<0.001).

“Evaluation of cerebral microbleeds and hypertension treatment complying with the established guidelines may be beneficial in the management of CAD patients,” the investigators said.