Is Antiplatelet Treatment Effective on the Progression of White Matter Hyperintensity? – 5 Year Follow Up, Propensity Score Adjusted, Observational Study (P04.203)

Objective: We performed this study to assess the effects of antiplatelet treatment on the progression of white matter change. Background White matter hyperintensity on MRI is commonly observed in asymptomatic elderly, and chronic ischemic insult is one of the postulated mechanisms. However, there is no consensus on the treatment of these patients, including the usage of antiplatelet. Design/Methods: From 2003 to 2005, subjects who performed brain MRI for health check up and showed mild white matter change only without any significant lesion on were selected, and follow up MRI were performed in 2010. During this period, patients were prescribed either antiplatelet or not according to the attending physician9s preference. White matter hyperintensity volume in FLAIR was blindly assessed by one investigator using 3D slicer imaging analysis software. For statistical comparison, propensity score weighting method was used. Results: Among 192 screened patients, 93 patients were followed and analyzed. The average interval between initial and follow up MR was 5.2 years. Male was 33 and mean age at the time of initial MR was 60.6 years old. Among them, 54 patients were taking antiplatelet during follow up period. Between the antiplatelet group and control, there was no difference in demographic and risk factor profiles except hypertension, which was more prevalent in those taking antiplatelet (38.9 vs. 15.4%, P=0.002). Compared to the control, the antiplatelet group also showed more severe baseline white matter lesion volume (1953 vs. 3963 mm3, P=0.002) and more progression of white matter change (1010 vs. 2944 mm3, P=0.001). When we adjusted the variables using inverse probability treatment weighting method, there was no difference between the two groups. Conclusions: Subjects with large white matter lesion volume on MRI were more likely to take antiplatelet, but there was no effect of antiplatelet on the progression of white matter hyperintensity. Disclosure: Dr. Rha has nothing to disclose. Dr. Park has nothing to disclose. Dr. Park has nothing to disclose. Dr. Yoo has nothing to disclose.