Portal de Periódicos da CAPES

Antiplatelet Therapy or Not for Asymptomatic/Incidental Lacunar Infarction

2023; Lippincott Williams & Wilkins; Volume: 54; Issue: 7 Linguagem: Inglês

10.1161/strokeaha.122.040444

1524-4628

Amanda Bilski, Hugo J. Aparicio, José Gutierrez, Frank–Erik de Leeuw, Nina A. Hilkens,

Parkinson's Disease Mechanisms and Treatments

HomeStrokeVol. 54, No. 7Antiplatelet Therapy or Not for Asymptomatic/Incidental Lacunar Infarction No AccessArticle CommentaryRequest AccessFull TextAboutView Full TextView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toNo AccessArticle CommentaryRequest AccessFull TextAntiplatelet Therapy or Not for Asymptomatic/Incidental Lacunar Infarction Amanda E. Bilski, Hugo J. Aparicio, Jose Gutierrez, Frank-Erik de Leeuw and Nina A. Hilkens Amanda E. BilskiAmanda E. Bilski Department of Neurology, New York Presbyterian Hospital/Columbia University Irving Medical Center (A.E.B., J.G.). , Hugo J. AparicioHugo J. Aparicio https://orcid.org/0000-0001-8584-1455 Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, MA (H.J.A.). Boston Medical Center, MA (H.J.A.). , Jose GutierrezJose Gutierrez https://orcid.org/0000-0002-2175-8078 Department of Neurology, New York Presbyterian Hospital/Columbia University Irving Medical Center (A.E.B., J.G.). , Frank-Erik de LeeuwFrank-Erik de Leeuw Correspondence to: Frank-Erik de Leeuw, MD, PhD, Radboud University Nijmegen Medical Center, Department of Neurology (HP 664), PO Box 9101, 6500 HB Nijmegen, the Netherlands. Email E-mail Address: [email protected] https://orcid.org/0000-0003-2221-3026 Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center Nijmegen, the Netherlands (F.-E.d.L., N.A.H.). and Nina A. HilkensNina A. Hilkens https://orcid.org/0000-0002-7757-6724 Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center Nijmegen, the Netherlands (F.-E.d.L., N.A.H.). Originally published16 May 2023https://doi.org/10.1161/STROKEAHA.122.040444Stroke. 2023;54:1954–1959FootnotesFor Sources of Funding and Disclosures, see page 1958.The opinions expressed in this article are not necessarily those of the editors or of the American Heart Association.Correspondence to: Frank-Erik de Leeuw, MD, PhD, Radboud University Nijmegen Medical Center, Department of Neurology (HP 664), PO Box 9101, 6500 HB Nijmegen, the Netherlands. Email frankerik.deleeuw@radboudumc.nlReferences1. Vernooij M, Ikram M, Tanghe H, Vincent A, Hofman A, Krestin G, Niessen W, Breteler M, van der Lugt A. Incidental findings on brain MRI in the general population.N Engl J Med. 2007; 357:1821–1828.CrossrefMedlineGoogle Scholar2. Vermeer SE, Longstreth WT, Koudstaal PJ. Silent brain infarcts: a systematic review.Lancet Neurol. 2007; 6:611–619. doi: 10.1016/S1474-4422(07)70170-9CrossrefMedlineGoogle Scholar3. Fanning JP, Wong AA, Fraser JF. The epidemiology of silent brain infarction: a systematic review of population-based cohorts.BMC Med. 2014; 12:119. doi: 10.1186/s12916-014-0119-0CrossrefMedlineGoogle Scholar4. Vermeer SE, Prins ND, den Heijer T, Hofman A, Koudstaal PJ, Breteler MM. Silent brain infarcts and the risk of dementia and cognitive decline.N Engl J Med. 2003; 348:1215–1222. doi: 10.1056/NEJMoa022066CrossrefMedlineGoogle Scholar5. Debette S, Beiser A, DeCarli C, Au R, Himali JJ, Kelly-Hayes M, Romero JR, Kase CS, Wolf PA, Seshadri S. Association of MRI markers of vascular brain injury with incident stroke, mild cognitive impairment, dementia, and mortality: the Framingham Offspring Study.Stroke. 2010; 41:600–606. doi: 10.1161/strokeaha.109.570044LinkGoogle Scholar6. Smith EE, Saposnik G, Biessels GJ, Doubal FN, Fornage M, Gorelick PB, Greenberg SM, Higashida RT, Kasner SE, Seshadri S, et al; American Heart Association Stroke Council; Council on Cardiovascular Radiology and Intervention; Council on Functional Genomics and Translational Biology; and Council on Hypertension. Prevention of Stroke in Patients With Silent Cerebrovascular Disease: a Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association.Stroke. 2017; 48:e44–e71. doi: 10.1161/STR.0000000000000116LinkGoogle Scholar7. Maestrini I, Altieri M, Di Clemente L, Vicenzini E, Pantano P, Raz E, Silvestrini M, Provinciali L, Paolino I, Marini C, et al. Longitudinal study on low-dose aspirin versus placebo administration in silent brain infarcts: the silence study.Stroke Res Treat. 2018; 2018:7532403. doi: 10.1155/2018/7532403CrossrefMedlineGoogle Scholar8. Wardlaw JM, Debette S, Jokinen H, De Leeuw FE, Pantoni L, Chabriat H, Staals J, Doubal F, Rudilosso S, Eppinger S, et al. ESO Guideline on covert cerebral small vessel disease.Eur Stroke J. 2021; 6:Cxi–clxii. doi: 10.1177/23969873211012132CrossrefGoogle Scholar9. Kwan J, Hafdi M, Chiang LW, Myint PK, Wong LS, Quinn TJ. Antithrombotic therapy to prevent cognitive decline in people with small vessel disease on neuroimaging but without dementia.Cochrane Database Syst Rev. 2022; 14:CD012269. doi: 10.1002/14651858.CD012269.pub2CrossrefGoogle Scholar10. Wardlaw JM, Smith EE, Biessels GJ, Cordonnier C, Fazekas F, Frayne R, Lindley RI, O'Brien JT, Barkhof F, Benavente OR, et al; STandards for ReportIng Vascular changes on nEuroimaging (STRIVE v1). Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration.Lancet Neurol. 2013; 12:822–838. doi: 10.1016/S1474-4422(13)70124-8CrossrefMedlineGoogle Scholar11. Wardlaw JM, Smith C, Dichgans M. Small vessel disease: mechanisms and clinical implications.Lancet Neurol. 2019; 18:684–696. doi: 10.1016/S1474-4422(19)30079-1CrossrefMedlineGoogle Scholar12. Agrawal N, Johnston SC, Wu YW, Sidney S, Fullerton HJ. Imaging data reveal a higher pediatric stroke incidence than prior US estimates.Stroke. 2009; 40:3415–3421. doi: 10.1161/STROKEAHA.109.564633LinkGoogle Scholar13. Minhas JS, Chithiramohan T, Wang X, Barnes SC, Clough RH, Kadicheeni M, Beishon LC, Robinson T. Oral antiplatelet therapy for acute ischaemic stroke.Cochrane Database Syst Rev. 2022; 14:CD000029. doi: 10.1002/14651858.CD000029.pub4CrossrefGoogle Scholar14. Antithrombotic Trialists Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients.Bmj. 2002; 324:71–86. doi: 10.1136/bmj.324.7329.71CrossrefMedlineGoogle Scholar15. Johnston SC, Easton JD, Farrant M, Barsan W, Conwit RA, Elm JJ, Kim AS, Lindblad AS, Palesch YY. Clopidogrel and aspirin in acute ischemic stroke and high-risk TIA.N Engl J Med. 2018; 379:215–225. doi: 10.1056/nejmoa1800410CrossrefMedlineGoogle Scholar16. Ter Telgte A, van Leijsen EMC, Wiegertjes K, Klijn CJM, Tuladhar AM, de Leeuw FE. Cerebral small vessel disease: from a focal to a global perspective.Nat Rev Neurol. 2018; 14:387–398. doi: 10.1038/s41582-018-0014-yCrossrefMedlineGoogle Scholar17. Mast H, Thompson JL, Völler H, Mohr JP, Marx P. Cardiac sources of embolism in patients with pial artery infarcts and lacunar lesions.Stroke. 1994; 25:776–781. doi: 10.1161/01.str.25.4.776LinkGoogle Scholar18. Guirguis-Blake JM, Evans CV, Perdue LA, Bean SI, Senger CA. Aspirin use to prevent cardiovascular disease and colorectal cancer: updated evidence report and systematic review for the US Preventive services task force.JAMA. 2022; 327:1585–1597. doi: 10.1001/jama.2022.3337CrossrefGoogle Scholar19. Baigent C, Blackwell L, Collins R, Emberson J, Godwin J, Peto R, Buring J, Hennekens C, Kearney P, Meade T, et al; Antithrombotic Trialists' (ATT) Collaboration. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials.Lancet. 2009; 373:1849–1860. doi: 10.1016/S0140-6736(09)60503-1CrossrefMedlineGoogle Scholar20. McNeil JJ, Wolfe R, Woods RL, Tonkin AM, Donnan GA, Nelson MR, Reid CM, Lockery JE, Kirpach B, Storey E, et al. Effect of aspirin on cardiovascular events and bleeding in the healthy elderly.N Engl J Med. 2018; 379:1509–1518. doi: 10.1056/nejmoa1805819CrossrefMedlineGoogle Scholar21. McNeil JJ, Woods RL, Nelson MR, Reid CM, Kirpach B, Wolfe R, Storey E, Shah RC, Lockery JE, Tonkin AM, et al; ASPREE Investigator Group. Effect of aspirin on disability-free survival in the healthy elderly.N Engl J Med. 2018; 379:1499–1508. doi: 10.1056/NEJMoa1800722CrossrefMedlineGoogle Scholar22. Kwok CS, Shoamanesh A, Copley HC, Myint PK, Loke YK, Benavente OR. Efficacy of antiplatelet therapy in secondary prevention following lacunar stroke.Stroke. 2015; 46:1014–1023. doi: 10.1161/STROKEAHA.114.008422LinkGoogle Scholar23. The SPS3 Investigators. Effects of clopidogrel added to aspirin in patients with recent lacunar stroke.N Engl J Med. 2012; 367:817–825. doi: 10.1056/NEJMoa1204133CrossrefMedlineGoogle Scholar24. Thoonsen H, Richard E, Bentham P, Gray R, van Geloven N, De Haan RJ, Van Gool WA, Nederkoorn PJ. Aspirin in Alzheimer's disease: increased risk of intracerebral hemorrhage: cause for concern?Stroke. 2010; 41:2690–2692. doi: 10.1161/STROKEAHA.109.576975LinkGoogle Scholar25. Michelson AD, Cattaneo M, Eikelboom JW, Gurbel P, Kottke-Marchant K, Kunicki TJ, Pulcinelli FM, Cerletti C, Rao AK; Platelet Physiology Subcommittee of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis. Aspirin resistance: position paper of the Working Group on Aspirin Resistance.J Thromb Haemost. 2005; 3:1309–1311. doi: 10.1111/j.1538-7836.2005.01351.xCrossrefMedlineGoogle Scholar26. Levine GN, Jeong YH, Goto S, Anderson JL, Huo Y, Mega JL, Taubert K, Smith SC. Expert consensus document: World Heart Federation expert consensus statement on antiplatelet therapy in East Asian patients with ACS or undergoing PCI.Nat Rev Cardiol. 2014; 11:597–606. doi: 10.1038/nrcardio.2014.104CrossrefMedlineGoogle Scholar27. Wardlaw JM, Lewis SC, Keir SL, Dennis MS, Shenkin S. Cerebral microbleeds are associated with lacunar stroke defined clinically and radiologically, independently of white matter lesions.Stroke. 2006; 37:2633–2636. doi: 10.1161/01.STR.0000240513.00579.bfLinkGoogle Scholar28. Howard VJ, McClure LA, Meschia JF, Pulley L, Orr SC, Friday GH. High prevalence of stroke symptoms among persons without a diagnosis of stroke or transient ischemic attack in a general population: the REasons for Geographic And Racial Differences in Stroke (REGARDS) study.Arch Intern Med. 2006; 166:1952–1958. doi: 10.1001/archinte.166.18.1952CrossrefMedlineGoogle Scholar29. Carey RM, Moran AE, Whelton PK. Treatment of hypertension: a review.JAMA. 2022; 328:1849–1861. doi: 10.1001/jama.2022.19590CrossrefMedlineGoogle Scholar30. Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, Braun LT, Ferranti S, Faiella-Tommasino J, Forman DE, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the management of blood cholesterol: executive summary.J Am Coll Cardiol. 2019; 73:3168–3209. doi: 10.1016/j.jacc.2018.11.002CrossrefMedlineGoogle Scholar31. ASCVD Risk Estimator Plus. American College of Cardiology.Accessed November 15. https://tools.acc.org/ASCVD-Risk-Estimator-Plus/#!/calculate/estimate/.Google Scholar32. Katsanos AH, Lioutas VA, Charidimou A, Catanese L, Ng KKH, Perera K, de Sa Boasquevisque D, Tsivgoulis G, Smith EE, Sharma M, et al. Statin treatment and accrual of covert cerebral ischaemia on neuroimaging: a systematic review and meta-analysis of randomized trials.Eur J Neurol. 2020; 27:1023–1027. doi: 10.1111/ene.14196CrossrefGoogle Scholar33. Fisher C. Lacunes: small, deep cerebral infarcts.Neurology. 1965; 15:774–784.CrossrefMedlineGoogle Scholar34. Moran C, Phan T, Srikanth V. Cerebral small vessel disease: a review of clinical, radiological, and histopathological phenotypes.Int J Stroke. 2012; 7:36–46. doi: 10.1111/j.1747-4949.2011.00725.xCrossrefMedlineGoogle Scholar35. Norrving B. Lacunar infarcts: no black holes in the brain are benign.Pract Neurol. 2008; 8:222–228. doi: 10.1136/jnnp.2008.153601CrossrefMedlineGoogle Scholar36. Fisher C. Lacunar stroke and infarcts: a review.Neurology. 1982; 32:871–876. doi: 10.1212/wnl.32.8.871CrossrefMedlineGoogle Scholar37. Leary M, Saver J. Annual incidence of first silent stroke in the United States: a preliminary estimate.Cerebrovasc Dis. 2003; 16:280–285.CrossrefMedlineGoogle Scholar38. Yue N, Longstreth W, Elster A, Jungreis C, O'Leary D, Poirier V. Clinically serious abnormalities found incidentally at MR imaging of the brain: data from the Cardiovascular Health Study.Radiology. 1997; 202:41–46. doi: 10.1148/radiology.202.1.8988190CrossrefMedlineGoogle Scholar39. Pantoni L, Poggesi A, Inzitari D. The relation between white-matter lesions and cognition.Curr Opin Neurol. 2007; 20:390–397. doi: 10.1097/WCO.0b013e328172d661CrossrefMedlineGoogle Scholar40. Prins N, van Dijk E, den Heijer T, Vermeer S, Jolles J, Koudstaal P, Hofman A, Breteler M. Cerebral small-vessel disease and decline in information processing speed, executive function and memory.Brain. 2005; 128:2034–2041. doi: 10.1093/brain/awh553CrossrefMedlineGoogle Scholar41. Longstreth W, Manolio T, Arnold A, Burke G, Bryan N, Jungreis C, Enright P, O'Leary D, Fried L. Clinical correlates of white matter findings on cranial magnetic resonance imaging of 3301 elderly people: the Cardiovascular Health Study.Stroke. 1996; 27:1274–1282. doi: 10.1161/01.str.27.8.1274LinkGoogle Scholar42. Au R, Massaro J, Wolf P, Young M, Beiser A, Seshadri S, D'Agostino R, DeCarli C. Association of white matter hyperintensity volume with decreased cognitive functioning: the Framingham Heart Study.Arch Neurol. 2006; 63:246–250. doi: 10.1001/archneur.63.2.246CrossrefMedlineGoogle Scholar43. Vermeer S, Den Heijer T, Koudstaal P, Oudkerk M, Hofman A, Breteler M. Incidence and risk factors of silent brain infarcts in the population-based Rotterdam Scan Study.Stroke. 2003; 34:392–396. doi: 10.1161/01.str.0000052631.98405.15LinkGoogle Scholar44. Reid C, Storey E, Wong T, Woods R, Tonkin A, Wang J, Kam A, Janke A, Essex R, Abhayaratna W, et al. Aspirin for the prevention of cognitive decline in the elderly: rationale and design of a neuro-vascular imaging study (ENVIS-ion).BMC Neurol. 2012; 12:1–9.Google Scholar45. Snowdon D, Greiner L, Mortimer J, Riley K, Greiner P, Markesbery W. Brain infarction and the clinical expression of Alzheimer disease. The Nun Study.JAMA. 1997; 277:813–817.CrossrefMedlineGoogle Scholar46. Gupta A, Giambrone A, Gialdini G, Finn C, Delgado D, Gutierrez J, Wright C, Beiser A, Seshadri S, Pandya A, et al. Silent brain infarction and risk of future stroke: a systematic review and meta-analysis.Stroke. 2016; 47:719–725. doi: 10.1161/STROKEAHA.115.011889LinkGoogle Scholar47. Wright CB, Dong C, Perez EJ, De Rosa J, Yoshita M, Rundek T, DeCarli C, Gutierrez J, Elkind MSV, Sacco RL. Subclinical cerebrovascular disease increases the risk of incident stroke and mortality: the Northern Manhattan study.J Am Heart Assoc. 2017; 6:e004069. doi: 10.1161/jaha.116.004069LinkGoogle Scholar48. Gutierrez J, Gil-Guevara A, Ramaswamy S, DeRosa J, Di Tullio MR, Cheung K, Rundek T, Sacco RL, Wright CB, Elkind MSV. Classification of covert brain infarct subtype and risk of death and vascular events.Stroke. 2020; 51:90–98. doi: 10.1161/STROKEAHA.119.026068LinkGoogle Scholar49. Diener H, Eikelboom J, Connolly S, Joyner C, Hart R, Lip G, O'Donnell M, Hohnloser S, Hankey G, Shestakovska O, et al. Apixaban versus aspirin in patients with atrial fibrillation and previous stroke or transient ischaemic attack: a predefined subgroup analysis from AVERROES, a randomised trial.Lancet Neurol. 2012; 11:225–231. doi: 10.1016/S1474-4422(12)70017-0CrossrefMedlineGoogle Scholar50. Norrving B. Long-term prognosis after lacunar infarction.Lancet Neurol. 2003; 2:238–245. doi: 10.1016/s1474-4422(03)00352-1CrossrefMedlineGoogle Scholar51. Cordonnier C, Al-Shahi R, Wardlaw J. Spontaneous brain microbleeds: systematic review, subgroup analyses and standards for study design and reporting.Brain. 2007; 130:1988–1203. doi: 10.1093/brain/awl387CrossrefMedlineGoogle Scholar52. Slark J, Bentley P, Sharma P. Silent brain infarction in the presence of systemic vascular disease.JRSM Cardiovasc Dis. 2012; 1:cvd.2012.012002. doi: 10.1258/cvd.2012.012002CrossrefGoogle Scholar53. Fanning J, Wesley A, Wong A, Fraser J. Emerging spectra of silent brain infarction.Stroke. 2014; 45:3461–3471. doi: 10.1161/STROKEAHA.114.005919LinkGoogle Scholar54. Kleindorfer D, Towfighi A, Chaturvedi S, Cockroft K, Gutierrez J, Lombardi-Hill D, Kamel H, Kernan W, Kittner S, Leira E, et al. 2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: a Guideline From the American Heart Association/American Stroke Association.Stroke. 2021; 52:e364–e467. doi: 10.1161/STR.0000000000000375LinkGoogle Scholar55. Sato H, Koretsune Y, Fukunami M, Kodama K, Yamada Y, Fujii K, Kitagawa K, Hori M. Aspirin attenuates the incidence of silent brain lesions in patients with nonvalvular atrial fibrillation.Circ J. 2004; 68:410–416. doi: 10.1253/circj.68.410CrossrefGoogle Scholar56. Matsumoto M. Cilostazol in secondary prevention of stroke: impact of the cilostazol stroke prevention study.Atheroscler Suppl. 2005; 6:33–40. doi: 10.1016/j.atherosclerosissup.2005.09.003CrossrefMedlineGoogle Scholar57. Fujita S, Kawaguchi T, Uehara T, Fukushima K. Progress of leukoaraiosis is inhibited by correction of platelet hyper-aggregability.Int Psychogeriatr. 2005; 17:689–698. doi: 10.1017/S104161020500164XCrossrefGoogle Scholar58. Li L, Geraghty OC, Mehta Z, Rothwell PM. Age-specific risks, severity, time course, and outcome of bleeding on long-term antiplatelet treatment after vascular events: a population-based cohort study.Lancet. 2017; 390:490–499. doi: 10.1016/s0140-6736(17)30770-5CrossrefMedlineGoogle Scholar59. Rothwell PM, Algra A, Chen Z, Diener HC, Norrving B, Mehta Z. Effects of aspirin on risk and severity of early recurrent stroke after transient ischaemic attack and ischaemic stroke: time-course analysis of randomised trials.Lancet. 2016; 388:365–375. doi: 10.1016/s0140-6736(16)30468-8CrossrefMedlineGoogle Scholar eLetters(0)eLetters should relate to an article recently published in the journal and are not a forum for providing unpublished data. Comments are reviewed for appropriate use of tone and language. Comments are not peer-reviewed. Acceptable comments are posted to the journal website only. Comments are not published in an issue and are not indexed in PubMed. Comments should be no longer than 500 words and will only be posted online. References are limited to 10. Authors of the article cited in the comment will be invited to reply, as appropriate.Comments and feedback on AHA/ASA Scientific Statements and Guidelines should be directed to the AHA/ASA Manuscript Oversight Committee via its Correspondence page.Sign In to Submit a Response to This Article Previous Back to top Next FiguresReferencesRelatedDetails July 2023Vol 54, Issue 7 Advertisement Article InformationMetrics © 2023 American Heart Association, Inc.https://doi.org/10.1161/STROKEAHA.122.040444PMID: 37191009 Manuscript receivedDecember 22, 2022Manuscript acceptedApril 11, 2023Originally publishedMay 16, 2023Manuscript revisedMarch 17, 2023 Keywordsbrain infarctionlacunarmagnetic resonance imagingprevalencerisk factorsPDF download Advertisement SubjectsCerebrovascular Disease/StrokeIschemic Stroke