HomeIngredientThe Influence of Select Medications on Prospective Hemorrhage Risk in Patients with Spinal or Cerebral Cavernous Malformations

The Influence of Select Medications on Prospective Hemorrhage Risk in Patients with Spinal or Cerebral Cavernous Malformations

April 4, 2022

World Neurosurg. 2022 Mar 29:S1878-8750(22)00395-3. doi: 10.1016/j.wneu.2022.03.101. Online ahead of print.

ABSTRACT

BACKGROUND: Effects of select medication on hemorrhage risk in patients with cerebral or spinal cavernous malformation (CM) are unknown.

METHODS: From a single-institution prospective cohort of patients with CM (2015-2021), demographics, mode of clinical presentation, and radiographic location data were collected. Follow-up was performed with electronic medical record review, in person visits and written surveys. Select medication use was ascertained from the time of the CM diagnosis to a censor date of first prospective symptomatic hemorrhage, complete surgical excision of sporadic form CM, last follow-up, or death. Using proportional hazards model (Cox Regression), we assessed effects of antithrombotic agents, fish oil, selective serotonin reuptake in inhibitors (SSRIs), Vitamin E and D supplementation, statin, and beta blockers on prospective hemorrhage risk.

RESULTS: 364 patients with spinal or cerebral CM (58.0% female; 20.0% familial; 42.3% presentation to medical attention due to hemorrhage; 25.8% brainstem) were included. During a follow-up of 2018 patient years, 103 prospective hemorrhages occurred. No studied medications increased prospective hemorrhage risk. Antithrombotic, Vitamin D supplementation, fish oil, and SSRI were associated with lower hemorrhage risk even after adjusting for age at diagnosis, hemorrhage at diagnosis, , and brainstem location.

CONCLUSIONS: Use of select medications with antithrombotic properties do not increase the risk of CM hemorrhage. Vitamin D supplementation, any antithrombotic, fish oil and SSRI were associated with a lower prospective hemorrhage risk. Further studies should evaluate the mechanism of action and potential benefit of these select medications.

PMID:35364298 | DOI:10.1016/j.wneu.2022.03.101

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About The Author

Patrick Blanchard MD

Meet Dr. Blanchard Dr. Blanchard’s medical practice is an embodiment of Integrative health which brings conventional and complementary approaches together in a coordinated way. Conveniently located in sunny Florida and over the internet with ValiseMD’s secure HIPPA compliant telXmed servers. Since 1994, patients with a wide range of challenging medical problems have achieved optimum health using the best of natural medicine, judiciously combined with high-tech innovations. Breakthroughs are often achieved even after patients have consulted mainstream specialists and holistic practitioners. Dr. Blanchard is founder and CEO of ValiseMD, Inc. He is board certified in Family Medicine since 1994 and awarded Fellow of the American Academy of Family Physicians in 2001. He received the ‘Teacher of the Year’ award from the University of Kansas School of Medicine at completion of his residency in Family Medicine. He completed a fellowship at Wake Forest University in the field of vascular neurosonology. He holds a medical patent in the field of Gastroenterology. He holds an unrestricted license to practice medicine and surgery in Florida. He started his medical career as a Emergency Medical Technician, then as a Paramedic and later a Medical Doctor.