Response by Werring and Charidimou to Letter Regarding Article, “Microbleeds, Cerebral Hemorrhage, and Functional Outcome After Stroke Thrombolysis: Individual Patient Data Meta-Analysis”
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We thank Tsivgoulis et al1 for their interest in our recent meta-analysis about the association of cerebral microbleeds (CMBs) on pretreatment magnetic resonance imaging (MRI) with outcomes, including symptomatic intracerebral hemorrhage (ICH), after intravenous thrombolysis for acute ischemic stroke.2
Consistent with our results, the aggregate data meta-analysis by Tsivgoulis et al1 also showed increased symptomatic ICH risk with >10 CMBs (relative risk, 12.10; 95% confidence interval, 4.36–33.57; P<0.001 compared with patients with 0–10 CMBs). Our study found a similar but smaller effect on symptomatic ICH (odds ratio for >10 CMBs, 3.65; 95% confidence interval, 1.17–11.42). The different results might be because we analyzed individual patient data from all 1973 patients, adjusted in robust multivariable models for key factors across the whole population, including treatment delay, age, baseline stroke severity, MRI sequence (T2*-gradient …