08/04/2021 at 7:11 PM #33652Anonymous UserParticipant
Cerebral haemorrhage caused by blood thinners?
Around one million people in Germany alone regularly take blood-thinning medication to prevent blood clotting. Above all, as protection against life-threatening illnesses such as strokes and heart attacks, these drugs are said to have a preventive effect. An international study has now examined in detail whether cerebral hemorrhage could not also be caused by blood thinners.
Complex clinical picture
The researchers from the University of Bern and University College London emphasized in a recent press release that cardiovascular diseases are usually complex and affect several organs at the same time. Treatments for vascular disease in the brain often make it necessary to adjust the treatment of heart disease. The most important thing is to understand the respective causes and effects exactly in order to be able to offer the best possible therapy. For this purpose, the research team also shed light on a possible connection between the risk of stroke in the case of atrial fibrillation.
Microangiopathies as a trigger
Strokes are usually not fatal and, depending on their severity, can be treated well with the help of various therapy options. In the case of cerebral haemorrhages, however, things look different: their frequency and danger have not decreased in the last 30 years. Previous studies have assessed blood thinners as additional risk factors for cerebral haemorrhage. In the current study, however, there was sufficient evidence that microangiopathy, a disease of the small blood vessels, must be a prerequisite for this: “The degree of microangiopathy in the brain is suitable for predicting cerebral hemorrhage. Without microangiopathy, on the other hand, the risk of cerebral hemorrhage is negligible. It follows from this that blood thinning should no longer be seen as the primary cause of cerebral hemorrhage, ”adds study author David Seffge from the University Hospital Bern.
Comparison of two studies provides evidence
Two independent, multi-center observational studies have been summarized in the current publication to provide precise evidence. One of them contained a cross-sectional study with 1,030 patients with cerebral haemorrhage, in which individual microangiopathies in the brain were detected using CT and MRI markers. In the other, prospective study, 1,447 people with atrial fibrillation and circulatory disorders were examined. The study focused on the occurrence of cerebral haemorrhages and strokes, depending on the thinning of the blood. The proof was achieved by comparing the risk factors: study participants who did not show any microangiopathy did not have a single cerebral hemorrhage in the context of the study. For participants with moderate to severe microangiopathy, however, the risk was increased by 1.56 percent per year.
Protection against stroke
The new findings will also help ensure that patients with a cerebral hemorrhage will continue to receive blood thinners in the future so that they are not exposed to a stroke without protection. Treatment of the causative microangiopathy should also be in the foreground in order to avoid cerebral hemorrhage. After adjusting the blood thinners, a certain level of protection against strokes can be maintained. “In order to prevent cerebral hemorrhage, microangiopathies should now be systematically searched for and specifically treated. (…) In this way, the risk of cerebral hemorrhage in the case of atrial fibrillation would be reduced both causally and effectively, ”says Prof. Marcel Arnold, Head Physician, Stroke Center, Inselspital, University Hospital Bern, summarizing the results.
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