{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T03:10:39Z","timestamp":1780542639030,"version":"3.54.1"},"reference-count":39,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2023,6,17]],"date-time":"2023-06-17T00:00:00Z","timestamp":1686960000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2023,6,17]],"date-time":"2023-06-17T00:00:00Z","timestamp":1686960000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"crossref","award":["32003B_197524"],"award-info":[{"award-number":["32003B_197524"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"crossref","award":["32473B_176178"],"award-info":[{"award-number":["32473B_176178"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"crossref","award":["33CS30_148474"],"award-info":[{"award-number":["33CS30_148474"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001711","name":"Swiss National Science Foundation","doi-asserted-by":"crossref","award":["33CS30_177520"],"award-info":[{"award-number":["33CS30_177520"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Stroke"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>An increased risk of intracranial hemorrhage (ICH) associated with statins has been reported, but data on the relationship between statin use and cerebral microbleeds (CMBs) in patients with atrial fibrillation (AF), a population at high bleeding and cardiovascular risk, are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims:<\/jats:title>\n                    <jats:p>To explore the association between statin use and blood lipid levels with the prevalence and progression of CMBs in patients with AF with a particular focus on anticoagulated patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Data of Swiss-AF, a prospective cohort of patients with established AF, were analyzed. Statin use was assessed during baseline and throughout follow-up. Lipid values were measured at baseline. CMBs were assessed using magnetic resonance imagining (MRI) at baseline and at 2\u2009years follow-up. Imaging data were centrally assessed by blinded investigators. Associations of statin use and low-density lipoprotein (LDL) levels with CMB prevalence at baseline or CMB progression (at least one additional or new CMB on follow-up MRI at 2\u2009years compared with baseline) were assessed using logistic regression models; the association with ICH was assessed using flexible parametric survival models. Models were adjusted for hypertension, smoking, body mass index, diabetes, stroke\/transient ischemic attack, coronary heart disease, antiplatelet use, anticoagulant use, and education.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of the 1693 patients with CMB data at baseline MRI (mean\u2009\u00b1\u2009SD age 72.5\u2009\u00b1\u20098.4 years, 27.6% women, 90.1% on oral anticoagulants), 802 patients (47.4%) were statin users. The multivariable adjusted odds ratio (adjOR) for CMBs prevalence at baseline for statin users was 1.10 (95% CI = 0.83\u20131.45). AdjOR for 1 unit increase in LDL levels was 0.95 (95% CI = 0.82\u20131.10). At 2\u2009years, 1188 patients had follow-up MRI. CMBs progression was observed in 44 (8.0%) statin users and 47 (7.4%) non-statin users. Of these patients, 64 (70.3%) developed a single new CMB, 14 (15.4%) developed 2 CMBs, and 13 developed more than 3 CMBs. The multivariable adjOR for statin users was 1.09 (95% CI = 0.66\u20131.80). There was no association between LDL levels and CMB progression (adjOR 1.02, 95% CI = 0.79\u20131.32). At follow-up 14 (1.2%) statin users had ICH versus 16 (1.3%) non-users. The age and sex adjusted hazard ratio (adjHR) was 0.75 (95% CI = 0.36\u20131.55). The results remained robust in sensitivity analyses excluding participants without anticoagulants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In this prospective cohort of patients with AF, a population at increased hemorrhagic risk due to anticoagulation, the use of statins was not associated with an increased risk of CMBs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17474930231181010","type":"journal-article","created":{"date-parts":[[2023,5,27]],"date-time":"2023-05-27T07:06:12Z","timestamp":1685171172000},"page":"1219-1227","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Association of statin use and lipid levels with cerebral microbleeds and intracranial hemorrhage in patients with atrial fibrillation: A prospective cohort study"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7713-7553","authenticated-orcid":false,"given":"Elisavet","family":"Moutzouri","sequence":"first","affiliation":[{"name":"Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland"},{"name":"Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland"},{"name":"Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Glutz","sequence":"additional","affiliation":[{"name":"Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nazanin","family":"Abolhassani","sequence":"additional","affiliation":[{"name":"Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland"},{"name":"Department of Epidemiology and Health Systems, Center for Primary Care and Public Health, (Unisant\u00e9), University of Lausanne, Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2519-836X","authenticated-orcid":false,"given":"Martin","family":"Feller","sequence":"additional","affiliation":[{"name":"Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luise","family":"Adam","sequence":"additional","affiliation":[{"name":"Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baris","family":"Gencer","sequence":"additional","affiliation":[{"name":"Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland"},{"name":"Department of Cardiology, HUG, University Hospital Geneva, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinzia","family":"Del Giovane","sequence":"additional","affiliation":[{"name":"Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvain","family":"B\u00e9trisey","sequence":"additional","affiliation":[{"name":"Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca E","family":"Paladini","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel, Basel University Hospital, University of Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2616-5535","authenticated-orcid":false,"given":"Elisa","family":"Hennings","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel, Basel University 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