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Outcome of intracerebral hemorrhage associated with different oral anticoagulants.
Wilson, Duncan; Seiffge, David J; Traenka, Christopher; Basir, Ghazala; Purrucker, Jan C; Rizos, Timolaos; Sobowale, Oluwaseun A; Sallinen, Hanne; Yeh, Shin-Joe; Wu, Teddy Y; Ferrigno, Marc; Houben, Rik; Schreuder, Floris H B M; Perry, Luke A; Tanaka, Jun; Boulanger, Marion; Al-Shahi Salman, Rustam; Jäger, Hans R; Ambler, Gareth; Shakeshaft, Clare; Yakushiji, Yusuke; Choi, Philip M C; Staals, Julie; Cordonnier, Charlotte; Jeng, Jiann-Shing; Veltkamp, Roland; Dowlatshahi, Dar; Engelter, Stefan T; Parry-Jones, Adrian R; Meretoja, Atte; Werring, David J.
Afiliação
  • Wilson D; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Seiffge DJ; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Traenka C; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Basir G; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Purrucker JC; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Rizos T; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Sobowale OA; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Sallinen H; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Yeh SJ; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Wu TY; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Ferrigno M; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Houben R; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Schreuder FHBM; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Perry LA; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Tanaka J; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Boulanger M; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Al-Shahi Salman R; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Jäger HR; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Ambler G; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Shakeshaft C; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Yakushiji Y; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Choi PMC; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Staals J; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Cordonnier C; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Jeng JS; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Veltkamp R; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Dowlatshahi D; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Engelter ST; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Parry-Jones AR; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Meretoja A; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
  • Werring DJ; From the Stroke Research Center (D.W., C.S., D.J.W.) and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair and Rehabilitation, Institute of Neurology, and Department of Statistical Science (G.A.), UCL, London, UK; Stroke Center and Neurology (D.J.S., C.T., S.T.E.), University Hosp
Neurology ; 88(18): 1693-1700, 2017 May 02.
Article em En | MEDLINE | ID: mdl-28381513
ABSTRACT

OBJECTIVE:

In an international collaborative multicenter pooled analysis, we compared mortality, functional outcome, intracerebral hemorrhage (ICH) volume, and hematoma expansion (HE) between non-vitamin K antagonist oral anticoagulation-related ICH (NOAC-ICH) and vitamin K antagonist-associated ICH (VKA-ICH).

METHODS:

We compared all-cause mortality within 90 days for NOAC-ICH and VKA-ICH using a Cox proportional hazards model adjusted for age; sex; baseline Glasgow Coma Scale score, ICH location, and log volume; intraventricular hemorrhage volume; and intracranial surgery. We addressed heterogeneity using a shared frailty term. Good functional outcome was defined as discharge modified Rankin Scale score ≤2 and investigated in multivariable logistic regression. ICH volume was measured by ABC/2 or a semiautomated planimetric method. HE was defined as an ICH volume increase >33% or >6 mL from baseline within 72 hours.

RESULTS:

We included 500 patients (97 NOAC-ICH and 403 VKA-ICH). Median baseline ICH volume was 14.4 mL (interquartile range [IQR] 3.6-38.4) for NOAC-ICH vs 10.6 mL (IQR 4.0-27.9) for VKA-ICH (p = 0.78). We did not find any difference between NOAC-ICH and VKA-ICH for all-cause mortality within 90 days (33% for NOAC-ICH vs 31% for VKA-ICH [p = 0.64]; adjusted Cox hazard ratio (for NOAC-ICH vs VKA-ICH) 0.93 [95% confidence interval (CI) 0.52-1.64] [p = 0.79]), the rate of HE (NOAC-ICH n = 29/48 [40%] vs VKA-ICH n = 93/140 [34%] [p = 0.45]), or functional outcome at hospital discharge (NOAC-ICH vs VKA-ICH odds ratio 0.47; 95% CI 0.18-1.19 [p = 0.11]).

CONCLUSIONS:

In our international collaborative multicenter pooled analysis, baseline ICH volume, hematoma expansion, 90-day mortality, and functional outcome were similar following NOAC-ICH and VKA-ICH.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Hemorragia Cerebral / Anticoagulantes Idioma: En Ano de publicação: 2017 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Hemorragia Cerebral / Anticoagulantes Idioma: En Ano de publicação: 2017 Tipo de documento: Article