Brain and behavior
Impact of Modifiable Cardiovascular Risk Factors and Protective Therapies on Hemorrhagic Events in Cerebral Cavernous Malformations: A Systematic Review and Meta-Analysis
Door Sanikommu S, Santos AN, Dawoud B en 8 anderen.
Inhoud in het Engels
Abstract
Background
Cerebral cavernous malformations (CCM) are vascular lesions prone to hemorrhage, but the influence of modifiable cardiovascular risk factors and commonly prescribed therapies on bleeding risk remains unclear.
Methods
We performed a systematic review and meta-analysis according to PRISMA 2020. PubMed/MEDLINE, Embase, and Scopus were searched from inception through August 31, 2025. Eligible observational studies and randomized trials reported adults with CCM stratified by modifiable cardiovascular risk factors or systemic therapies. Hemorrhagic presentation at diagnosis and prospective symptomatic hemorrhage or rebleeding during follow-up were extracted and interpreted as distinct clinical endpoints. Comparable adjusted and crude estimates were pooled separately using random-effects models; randomized trials with non-comparable populations or endpoints were summarized narratively. Risk of bias and certainty of evidence were assessed using design-appropriate Cochrane tools and GRADE, respectively.