Article
Medication intake and haemorrhage risk in patients with familial cerebral caverneous malformations
Medikamenteneinnahme und Blutungsrisiko bei Patienten mit familiären zerebralen kavernösen Malformationen
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Published: | May 25, 2022 |
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Objective: To analyze the impact of medication intake on hemorrhage risk in patients with familial cerebral cavernous malformation (FCCM)
Methods: Our institutional database was screened for patients with FCCM admitted between 2003 and 2020. Patients with complete magnetic resonance imaging (MRI) dataset, evidence of multiple CCM, clinical baseline characteristics, and follow-up examination were included. We assessed the influence of medication intake on first or recurrent intracerebral hemorrhage (ICH) using univariate and multivariate logistic regression adjusted for age and sex. The longitudinal cumulative 5-year-risk for (re-)hemorrhage was calculated by applying Kaplan Meier and Cox regression analyses adjusted for age and sex
Results: 205 patients with FCCM were included. Univariate Cox regression analysis identified ICH as a predictor for recurrent hemorrhage during the 5-year follow-up (FU). Although not statistically significant, there was a considerably decreased risk of ICH during FU in patients under statin medication (HR: 0.22 [95% CI, 0.03-1.68], P=0.143). No bleeding events were observed in patients under antithrombotic therapy. Kaplan-Meier and log rank test showed a considerable low risk of ICH in patients under antithrombotic (P=0.085), as well as statin (P=0.193) therapy during follow-up. The cumulative 5-year risk of (re)bleeding was 22.82% (95% CI, 17.33%-29.38%) for the entire cohort, 31.41% (95% CI, 23.26%-40.83%) for patients with a history of ICH, 26.54% (95% CI, 11.13%-49.7%) for individuals under beta blocker medication, 6.25% (95% CI, 0.33%-32.29%) for patients under statin medication, and 0% (95% CI, 0%-30.13%) for patients under antithrombotic medication
Conclusion: ICH was identified as a risk factor for recurrent hemorrhage. Although not statistically significant, statin and antithrombotic medication reveal a trend in preventing bleeding events
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