A clinical study of the association between white matter hyperintensity, aspirin therapy and cerebral microbleeds

Objective To investigate the association between white matter hyperintensity (WMH), aspirin therapy and cerebral microbleeds (CMBs), and to screen risk factors for CMBs and severity of CMBs. Methods Total 2654 patients with ischemic cerebrovascular disease were admitted to Department of Neurology in Beijing Chao⁃Yang Hospital, Capital Medical University from June 2016 to February 2021. Systolic blood pressure (SBP), diastolic blood pressure (DBP), aspirin therapy, time of aspirin therapy, high⁃density lipoprotein cholesterol (HDL⁃C) and low⁃density lipoprotein cholesterol (LDL⁃C) of the serum, glycated hemoglobin (HbA1c), homocysteine (Hcy), fibrinogen (FIB) and D⁃dimer of plasma were collected within 24 h of admission. MRI was used to evaluate the severity of WMH by Fazekas score and identify the number of CMBs by Microbleed Anatomical Rating Scale (MARS). Univariate and multivariate stepwise Logistic regression analyses were used to screen the related risk factors for CMBs and its severity. Results Total 2654 patients were divided into control group (n=1315), mild (n=461), moderate (n=440) and severe (n=438) WMH groups by Fazekas score. There was statistically significant difference in age (H=353.837, P=0.000), history of hypertension (χ2=79.818, P=0.000), coronary heart disease (χ2=56.768, P=0.000) and diabetes (χ2=8.936, P=0.030), SBP at admission (H=47.979, P=0.000), aspirin therapy (χ2=161.576, P=0.000), time of aspirin therapy (H=4.766, P=0.000), serum LDL⁃C (H=16.533, P=0.002), plasma HbA1c (H=22.127, P=0.000) and Hcy (H=83.558, P=0.002), proportion of CMBs (χ2=642.054, P=0.000) among groups. Logistic regression analysis showed that DBP at admission (OR=1.017, 95%CI: 1.007-1.026, P=0.001; OR=1.020, 95%CI: 1.011-1.029, P=0.000) and Fazekas score (OR=1.673, 95%CI: 1.590-1.761, P=0.000; OR=1.754, 95%CI: 1.669-1.844, P=0.000) were risk factors for CMBs and its severity. Serum LDL⁃C was a protective factor for CMBs and its severity (OR=0.856, 95%CI: 0.765-0.957, P=0.006; OR=0.860, 95%CI: 0.774-0.956, P=0.005). Aspirin therapy and time of aspirin therapy were not significantly correlated with CMBs and its severity. Conclusions Severity of WMH (Fazekas score) was a risk factor for CMBs and its severity.