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Supplemental material, sj-docx-1-wso-10.1177_17474930231181010 for Association of statin use and lipid levels with cerebral microbleeds and intracranial hemorrhage in patients with atrial fibrillation: A prospective cohort study by Elisavet Moutzouri, Matthias Glutz, Nazanin Abolhassani, Martin Feller, Luise Adam, Baris Gencer, Cinzia Del Giovane, Sylvain Bétrisey, Rebecca E Paladini, Elisa Hennings, Stefanie Aeschbacher, Jürg H Beer, Giorgio Moschovitis, David Seiffge, Gian Marco De Marchis, Michael Coslovsky, Tobias Reichlin, Giulio Conte, Tim Sinnecker, Matthias Schwenkglenks, Leo H Bonati, Peter Kastner, Drahomir Aujesky, Michael Kühne, Stefan Osswald, Urs Fischer, David Conen and Nicolas Rodondi in International Journal of Stroke

Background: 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. Aims: To explore the association between statin-use and blood lipid-levels with the prevalence and progression of CMBs in patients with atrial fibrillation with particular focus on anticoagulated patients. Methods: 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-years 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-years compared to 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. Results: Of the 1693 patients with CMB data at baseline MRI (mean±SD age 72.5±8.4y, 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, 0.83–1.45). AdjOR for 1 unit increase in LDL-levels was 0.95 (95% CI, 0.82–1.10). At 2-years, 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, 0.66–1.80). There was no association between LDL-levels and CMBs progression (adjOR 1.02, 95% CI, 0.79–1.32). At follow-up 14 (1.2%) statin users had ICH vs 16 (1.3%) non-users. The age and sex adjusted Hazard Ratio (adjHR) was 0.75 (95% CI, 0.36–1.55). Results remained robust in sensitivity analyses excluding participants without anticoagulants. Conclusions: 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.

Supplemental material, sj-docx-1-wso-10.1177_17474930231181010 for Association of statin use and lipid levels with cerebral microbleeds and intracranial hemorrhage in patients with atrial fibrillation: A prospective cohort study by Elisavet Moutzouri, Matthias Glutz, Nazanin Abolhassani, Martin Feller, Luise Adam, Baris Gencer, Cinzia Del Giovane, Sylvain Bétrisey, Rebecca E Paladini, Elisa Hennings, Stefanie Aeschbacher, Jürg H Beer, Giorgio Moschovitis, David Seiffge, Gian Marco De Marchis, Michael Coslovsky, Tobias Reichlin, Giulio Conte, Tim Sinnecker, Matthias Schwenkglenks, Leo H Bonati, Peter Kastner, Drahomir Aujesky, Michael Kühne, Stefan Osswald, Urs Fischer, David Conen and Nicolas Rodondi in International Journal of Stroke

Additional file 1. Supplemental material.

Multimorbidity and age-physiological functional restrictions can lead to frailty and a loss of a self-determined life in elderly patients. The Timed Up-and-Go test (TUG) is a sensitive and specific measure of frailty and has also many other areas of application, for example in chronic diseases. Besides the measurement of the complete TUG time, the analysis of subtasks may also reveal important information about particular aspects of the health status of test subjects. We developed an ultrasonic-based device for performing the TUG automatically, which can be attached to the backrest of a chair. This device provides the total TUG time as well as the displacement-time data for all included subtasks. To prepare for its use in clinical studies, we performed a field test at a geriatric center. The goal was to confirm feasibility, i.e., to assess its application in real patients. Despite some improvement potential revealed by the field test, the concept turned out to be an appropriate method for monitoring the TUG time and its subtasks.