{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T11:27:49Z","timestamp":1774438069514,"version":"3.50.1"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2013,9,26]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Although clopidogrel reduces the incidence of atherothrombotic events, its use is associated with an increased risk of major bleeding. Cerebral microbleeds (\n              <jats:styled-content style=\"fixed-case\">CMB<\/jats:styled-content>\n              s) are indicative of subclinical microangiopathy in the brain and may prelude symptomatic intracerebral hemorrhage. We examined the association between use of clopidogrel and\n              <jats:styled-content style=\"fixed-case\">CMB<\/jats:styled-content>\n              s in persons without a history of stroke.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We performed a cross\u2010sectional analysis using data from the Rotterdam Study, a prospective population\u2010based cohort of persons aged 45\u00a0years and older. Among 4408 stroke\u2010free individuals who underwent brain magnetic resonance imaging for the detection of\n              <jats:styled-content style=\"fixed-case\">CMB<\/jats:styled-content>\n              s, we identified 121 ever\u2010users and 4287 never\u2010users of clopidogrel before magnetic resonance imaging. We used multiple logistic regression to analyze the association between clopidogrel and\n              <jats:styled-content style=\"fixed-case\">CMB<\/jats:styled-content>\n              s with adjustment for age, sex, cardiovascular risk factors, and common cardiovascular medication. Users of clopidogrel had a higher prevalence of\n              <jats:styled-content style=\"fixed-case\">CMB<\/jats:styled-content>\n              s (odd ratio 1.55,\n              <jats:styled-content style=\"fixed-case\">95% CI<\/jats:styled-content>\n              1.01 to 2.37) than nonusers and more often had a high number (&gt;4) of\n              <jats:styled-content style=\"fixed-case\">CMB<\/jats:styled-content>\n              s (odds ratio 3.19, 95% CI 1.52 to 6.72). Clopidogrel use was associated with a significantly higher prevalence of deep or infratentorial\n              <jats:styled-content style=\"fixed-case\">CMB<\/jats:styled-content>\n              s (odd ratio 1.90, 95% CI 1.05 to 3.45). Among clopidogrel users, we were unable to demonstrate differences in the prevalence of\n              <jats:styled-content style=\"fixed-case\">CMB<\/jats:styled-content>\n              s by indication of prescription, history of coronary heart disease, or common genetic variants in\n              <jats:italic>\n                <jats:styled-content style=\"fixed-case\">CYP<\/jats:styled-content>\n                2C19\n              <\/jats:italic>\n              .\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In stroke\u2010free individuals, clopidogrel use was associated with a higher prevalence and higher number of\n              <jats:styled-content style=\"fixed-case\">CMB<\/jats:styled-content>\n              s. Whether this association is causal requires confirmation in prospective studies, especially given the small number of participants taking clopidogrel and the possibility of residual confounding in this study.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.113.000359","type":"journal-article","created":{"date-parts":[[2013,9,27]],"date-time":"2013-09-27T03:23:55Z","timestamp":1380252235000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":32,"title":["Clopidogrel Use Is Associated With an Increased Prevalence of Cerebral Microbleeds in a Stroke\u2010Free Population: The Rotterdam Study"],"prefix":"10.1161","volume":"2","author":[{"given":"Sirwan K.L.","family":"Darweesh","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maarten 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