Authors' reply to “Statin treatment and cerebral microbleeds: A risk assessment”

Published:October 21, 2021DOI:https://doi.org/10.1016/j.jns.2021.120037
      We appreciate Dr. Kawada for his interest in our systematic review and meta-analysis investigating the association between statin treatment and cerebral microbleeds (CMBs) [
      • Kawada T.
      Statin treatment and cerebral microbleeds: a risk assessment.
      ]. In this systematic review and meta-analysis we analyzed cross-sectional evidence from available cohorts nested within randomized-controlled clinical trials or observational studies [
      • Katsanos A.H.
      • Lioutas V.A.
      Charidimou A, et al.
      ]. In the overall analysis statin treatment was not found to be associated with CMBs presence, but when the analysis was restricted to lobar CMBs the association between statin use and the probability for lobar CMBs presence was positive [
      • Katsanos A.H.
      • Lioutas V.A.
      Charidimou A, et al.
      ]. We agree with Dr. Kawada that stratifying the risk based on the indication of statin use (primary vs. secondary) and comorbidities would have been helpful, but these data elements were not always available. Acknowledging the limitations of the studies included in the meta-analysis and our inability to evaluate the temporal association between statin intake and CMBs formation or stratify for comorbidities, we highlighted that the findings of our meta-analysis should be regarded as purely exploratory and hypothesis generating [
      • Katsanos A.H.
      • Lioutas V.A.
      Charidimou A, et al.
      ].
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