Outcome of intracerebral hemorrhage associated with different oral anticoagulants

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Wilson , D , Seiffge , D J , Traenka , C , Basir , G , Purrucker , J C , Rizos , T , Sobowale , O A , Sallinen , H , Yeh , S-J , Wu , T Y , Ferrigno , M , Houben , R , Schreuder , F H B M , Perry , L A , Tanaka , J , Boulanger , M , Salman , R A-S , Jaeger , H R , Ambler , G , Shakeshaft , C , Yakushiji , Y , Choi , P M C , Staals , J , Cordonnier , C , Jeng , J-S , Veltkamp , R , Dowlatshahi , D , Engelter , S T , Parry-Jones , A R , Meretoja , A , Werring , D J & CROMIS-2 Collaborators 2017 , ' Outcome of intracerebral hemorrhage associated with different oral anticoagulants ' , Neurology , vol. 88 , no. 18 , pp. 1693-1700 . https://doi.org/10.1212/WNL.0000000000003886

Title: Outcome of intracerebral hemorrhage associated with different oral anticoagulants
Author: 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; Salman, Rustam Al-Shahi; Jaeger, 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.; CROMIS-2 Collaborators
Contributor: University of Helsinki, Department of Neurosciences
Date: 2017-05-02
Language: eng
Number of pages: 8
Belongs to series: Neurology
ISSN: 0028-3878
URI: http://hdl.handle.net/10138/195658
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 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.
Subject: THROMBIN INHIBITOR DABIGATRAN
ATRIAL-FIBRILLATION
INTRACRANIAL HEMORRHAGE
WARFARIN
TRIAL
REVERSAL
RIVAROXABAN
VOLUME
IDARUCIZUMAB
MANAGEMENT
3112 Neurosciences
3124 Neurology and psychiatry
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