Cerebral microbleeds in geriatric patients with non-valvular atrial fibrillation

Aim. To study the prevalence and structure of cerebral microbleeds (CMBs) in patients ≥80 years old with non-valvular atrial fibrillation in real-world practice.

Material and methods. Eighty patients were examined (median age 83 (81; 86) years, 72,5% women). All patients underwent brain magnetic resonance imaging using a MAGNETOM Skyra system 3 Tesla (Siemens) during the initial examination and again one year later.

Results. During the initial examination, the detection rate of CMBs was 48,8% and did not differ significantly depending on the direct oral anticoagulant taken (p=0,738). There were 161 CMBs in 39 patients (an average of 4,1±3,6 CMBs per patient). During the repeated examination, newly detected CMBs were in 21,6% of patients. In the initial examination, mixed location of CMBs prevailed (43,6%), mainly in the frontal lobe (25,5%), while in reexamination, lobar location (54,5%) and also mainly in the frontal lobe (43,5%).

Conclusion. The high detection rate of CMBs in patients ≥80 years with non-valvular atrial fibrillation, both at the initial examination and after one year, especially in the lobar location, indicates a high risk of intracranial hemorrhage. Its prevention requires a multidisciplinary approach to the management of such patients.

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