TY - JOUR
T1 - Common medications and intracerebral hemorrhage
T2 - The aric study
AU - Sharma, Richa
AU - Matsushita, Kunihiro
AU - Wu, Aozhou
AU - Jack, Clifford R.
AU - Griswold, Michael
AU - Mosley, Thomas H.
AU - Fornage, Myriam
AU - Gottesman, Rebecca F.
N1 - Funding Information:
Dr Sharma was supported as a StrokeNet Research Fellow by National Institutes of Health (NIH) U10 NS08672. Dr Gottesman is supported by National Institute on Aging (NIA) grant K24 AG052573. Dr Jack is funded by the NIH and the Alexander Family Alzheimer’s Disease Research Professorship of the Mayo Clinic. The ARIC (Atherosclerosis Risk in Communities) study is performed as a collaborative study supported by National Heart, Lung, and Blood Institute (NHLBI) contracts (HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700005I, and HHSN268201700004I). Neurocognitive data were collected by U01 2U01HL096812, 2U01HL096814, 2U01HL096899, 2U01HL096902, and
Funding Information:
Dr Sharma was supported as a StrokeNet Research Fellow by National Institutes of Health U10 NS08672. Dr Gottesman is Associate Editor for the journal, Neurology. Dr Jack is a Lily consultant, monitors data for Roche, and speaks for Eisai, but receives no compensation from any commercial entity. The remaining authors have no disclosures to report.
Funding Information:
2U01HL096917 from the NIH (NHLBI, National Institute of Neurological Disorders and Stroke, NIA, and National Institute on Deafness and Other Communication Disorders), and with previous brain magnetic resonance imaging examinations funded by R01-HL70825 from the NHLBI.
Publisher Copyright:
© 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
PY - 2021
Y1 - 2021
N2 - BACKGROUND: Antiplatelets, anticoagulants, and statins are commonly prescribed for various indications. The associations between these medications and the risk of intracerebral hemorrhage (ICH) and cerebral microbleeds (CMBs) are unclear. METHODS AND RESULTS: We performed a retrospective study of the ARIC (Atherosclerosis Risk in Communities) study cohort, recruited from 4 US communities in 1987 to 1989 with follow-up. In 2011 to 2013, a subset (N=1942) underwent brain magnetic resonance imaging with CMB evaluation. Time-varying and any antiplatelet, anticoagulant, or statin use was evaluated at subsequent study visits in participants not on each medication at baseline. To determine the hazard of ICH and odds of CMB by medication use, logistic and Cox proportional hazard models were built, respectively, adjusting for the propensity to take the medication, concomitant use of other medications, and cognitive, genetic, and radiographic data. Of 15 719 individuals during up to 20 years of follow-up, 130 participants experienced an ICH. The adjusted hazard of ICH was significantly lower among participants taking an antiplatelet at the most recent study visit before ICH versus nonusers (hazard ratio [HR], 0.53; 95% CI, 0.30–0.92). Statin users had a significantly lower hazard of an ICH compared with nonusers (adjusted HR, 0.13; 95% CI, 0.05–0.34). There was no association of CMB and antiplatelet, anticoagulant, or statin use in adjusted models. CONCLUSIONS: In this US community-based study, antiplatelet and statin use were associated with lower ICH hazard, whereas no association was noted between CMBs and antiplatelets, anticoagulants, and statins. Further study is needed to understand the differential roles of these medications in cerebral microhemorrhages and macrohemorrhages.
AB - BACKGROUND: Antiplatelets, anticoagulants, and statins are commonly prescribed for various indications. The associations between these medications and the risk of intracerebral hemorrhage (ICH) and cerebral microbleeds (CMBs) are unclear. METHODS AND RESULTS: We performed a retrospective study of the ARIC (Atherosclerosis Risk in Communities) study cohort, recruited from 4 US communities in 1987 to 1989 with follow-up. In 2011 to 2013, a subset (N=1942) underwent brain magnetic resonance imaging with CMB evaluation. Time-varying and any antiplatelet, anticoagulant, or statin use was evaluated at subsequent study visits in participants not on each medication at baseline. To determine the hazard of ICH and odds of CMB by medication use, logistic and Cox proportional hazard models were built, respectively, adjusting for the propensity to take the medication, concomitant use of other medications, and cognitive, genetic, and radiographic data. Of 15 719 individuals during up to 20 years of follow-up, 130 participants experienced an ICH. The adjusted hazard of ICH was significantly lower among participants taking an antiplatelet at the most recent study visit before ICH versus nonusers (hazard ratio [HR], 0.53; 95% CI, 0.30–0.92). Statin users had a significantly lower hazard of an ICH compared with nonusers (adjusted HR, 0.13; 95% CI, 0.05–0.34). There was no association of CMB and antiplatelet, anticoagulant, or statin use in adjusted models. CONCLUSIONS: In this US community-based study, antiplatelet and statin use were associated with lower ICH hazard, whereas no association was noted between CMBs and antiplatelets, anticoagulants, and statins. Further study is needed to understand the differential roles of these medications in cerebral microhemorrhages and macrohemorrhages.
KW - Cohort studies
KW - Intracerebral hemorrhage
KW - Medications
UR - http://www.scopus.com/inward/record.url?scp=85102486421&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85102486421&partnerID=8YFLogxK
U2 - 10.1161/JAHA.120.014270
DO - 10.1161/JAHA.120.014270
M3 - Article
C2 - 33586464
AN - SCOPUS:85102486421
SN - 2047-9980
VL - 10
SP - 1
EP - 21
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 5
M1 - e014270
ER -