The Clinical Relevance of Microbleeds in Stroke study (CROMIS‐2): rationale, design, and methods

Background and rationaleThe increasing use of oral anticoagulants, mostly to prevent ischemic stroke due to atrial fibrillation in an ageing population, has been associated with a fivefold increased incidence of oral anticoagulant‐associated intracerebral hemorrhage: a rare, serious, and unpredictable complication. We hypothesize that cerebral microbleeds and other markers of cerebral small vessel disease on magnetic resonance imaging, and genetic polymorphisms (e.g. influencing cerebral small vessel integrity or anticoagulation stability), are associated with an increased risk of oral anticoagulant‐associated intracerebral hemorrhage, with potential to improve risk prediction. Aims(1) To determine the incidence, clinical, radiological, and genetic associations of oral anticoagulant‐associated intracerebral hemorrhage in a prospective, multicentre cohort study of patients with atrial fibrillation‐related ischemic stroke or transient ischemic attack started on oral anticoagulants; (2) To investigate characteristics of oral anticoagulant‐associated intracerebral hemorrhage compared with non‐oral anticoagulants related intracerebral hemorrhage in a prospective study. Design and methodsStudy 1: Prospective, multicentre, inception cohort study of 1425 adults started on oral anticoagulants (including vitamin K antagonists and the nonvitamin K oral anticoagulants) after recent ischemic stroke and concurrent atrial fibrillation. Participants will have standardized brain m...
Source: International Journal of Stroke - Category: Neurology Authors: Tags: Protocol Source Type: research