No significant association of aspirin use with cerebral microbleeds in the asymptomatic elderly

Background and purpose: Cerebral microbleeds (CMBs) may predict future risk for intracerebral hemorrhage (ICH). ICH is one of the most important complications of aspirin use. The association between aspirin use and CMBs is still controversial. In this context, we sought to investigate whether aspirin use is associated with CMBs in subjects without previous history of stroke.

Methods: Asymptomatic elderly subjects (n=1452; age ≥ 65 years) who visited for routine health check-ups were included in this study. CMBs were evaluated through T2*-weighted gradient-recalled echo MRI. Information about aspirin or warfarin use was obtained using a structured questionnaire.

Results: A total of 138 subjects (9.5%) were found to have CMBs. In the group of aspirin use, 43 subjects (11.2%) had CMBs; among them 9 (2.3%) had strictly lobar microbleeds and 34 (8.9%) had deep or infratentorial microbleeds. Compared with the non-use group, the risk for CMBs did not increase in the group of aspirin use (adjusted odds ratio, 1.10; 95% confidence interval, 0.73-1.66). For the group of aspirin use above 5 years, the proportion of CMBs (11.1%) did not increase compared with the group of short-term use (≤ 5 years, 9.5%, p=0.99) and non-use group (8.9%, p=0.66).

Conclusions: We found that the prevalence of CMBs did not increase in the group of aspirin use, and the presence of CMBs was not associated with the duration of aspirin use in asymptomatic elderly subjects without a history of stroke or transient ischemic attack.