Neuroimaging and clinical outcomes of oral anticoagulant-associated intracerebral hemorrhage

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Tsivgoulis , G , Wilson , D , Katsanos , A H , Sargento-Freitas , J , Marques-Matos , C , Azevedo , E , Adachi , T , von der Brelie , C , Aizawa , Y , Abe , H , Tomita , H , Okumura , K , Hagii , J , Seiffge , D J , Lioutas , V-A , Traenka , C , Varelas , P , Basir , G , Krogias , C , Purrucker , J C , Sharma , V K , Rizos , T , Mikulik , R , Sobowale , O A , Barlinn , K , Sallinen , H , Goyal , N , Yeh , S-J , Karapanayiotides , T , Wu , T Y , Vadikolias , K , Ferrigno , M , Hadjigeorgiou , G , Houben , R , Giannopoulos , S , Schreuder , F H B M , Chang , J J , Perry , L A , Mehdorn , M , Marto , J-P , Pinho , J , Tanaka , J , Boulanger , M , Salman , R A-S , Jaeger , H R , 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 , Mitsias , P D , Alexandrov , A V , Ambler , G & Werring , D J 2018 , ' Neuroimaging and clinical outcomes of oral anticoagulant-associated intracerebral hemorrhage ' , Annals of Neurology , vol. 84 , no. 5 , pp. 694-704 . https://doi.org/10.1002/ana.25342

Title: Neuroimaging and clinical outcomes of oral anticoagulant-associated intracerebral hemorrhage
Author: Tsivgoulis, Georgios; Wilson, Duncan; Katsanos, Aristeidis H.; Sargento-Freitas, Joao; Marques-Matos, Claudia; Azevedo, Elsa; Adachi, Tomohide; von der Brelie, Christian; Aizawa, Yoshifusa; Abe, Hiroshi; Tomita, Hirofumi; Okumura, Ken; Hagii, Joji; Seiffge, David J.; Lioutas, Vasileios-Arsenios; Traenka, Christopher; Varelas, Panayiotis; Basir, Ghazala; Krogias, Christos; Purrucker, Jan C.; Sharma, Vijay K.; Rizos, Timolaos; Mikulik, Robert; Sobowale, Oluwaseun A.; Barlinn, Kristian; Sallinen, Hanne; Goyal, Nitin; Yeh, Shin-Joe; Karapanayiotides, Theodore; Wu, Teddy Y.; Vadikolias, Konstantinos; Ferrigno, Marc; Hadjigeorgiou, Georgios; Houben, Rik; Giannopoulos, Sotirios; Schreuder, Floris H. B. M.; Chang, Jason J.; Perry, Luke A.; Mehdorn, Maximilian; Marto, Joao-Pedro; Pinho, Joao; Tanaka, Jun; Boulanger, Marion; Salman, Rustam Al-Shahi; Jaeger, Hans R.; 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; Mitsias, Panayiotis D.; Alexandrov, Andrei V.; Ambler, Gareth; Werring, David J.
Contributor: University of Helsinki, Neurologian yksikkö
University of Helsinki, Clinicum
Date: 2018-11
Language: eng
Number of pages: 11
Belongs to series: Annals of Neurology
ISSN: 0364-5134
URI: http://hdl.handle.net/10138/307708
Abstract: Objective Methods Whether intracerebral hemorrhage (ICH) associated with non-vitamin K antagonist oral anticoagulants (NOAC-ICH) has a better outcome compared to ICH associated with vitamin K antagonists (VKA-ICH) is uncertain. We performed a systematic review and individual patient data meta-analysis of cohort studies comparing clinical and radiological outcomes between NOAC-ICH and VKA-ICH patients. The primary outcome measure was 30-day all-cause mortality. All outcomes were assessed in multivariate regression analyses adjusted for age, sex, ICH location, and intraventricular hemorrhage extension. Results Interpretation We included 7 eligible studies comprising 219 NOAC-ICH and 831 VKA-ICH patients (mean age = 77 years, 52.5% females). The 30-day mortality was similar between NOAC-ICH and VKA-ICH (24.3% vs 26.5%; hazard ratio = 0.94, 95% confidence interval [CI] = 0.67-1.31). However, in multivariate analyses adjusting for potential confounders, NOAC-ICH was associated with lower admission National Institutes of Health Stroke Scale (NIHSS) score (linear regression coefficient = -2.83, 95% CI = -5.28 to -0.38), lower likelihood of severe stroke (NIHSS > 10 points) on admission (odds ratio [OR] = 0.50, 95% CI = 0.30-0.84), and smaller baseline hematoma volume (linear regression coefficient = -0.24, 95% CI = -0.47 to -0.16). The two groups did not differ in the likelihood of baseline hematoma volume <30cm(3) (OR = 1.14, 95% CI = 0.81-1.62), hematoma expansion (OR = 0.97, 95% CI = 0.63-1.48), in-hospital mortality (OR = 0.73, 95% CI = 0.49-1.11), functional status at discharge (common OR = 0.78, 95% CI = 0.57-1.07), or functional status at 3 months (common OR = 1.03, 95% CI = 0.75-1.43). Although functional outcome at discharge, 1 month, or 3 months was comparable after NOAC-ICH and VKA-ICH, patients with NOAC-ICH had smaller baseline hematoma volumes and less severe acute stroke syndromes. Ann Neurol 2018;84:702-712
Subject: VITAMIN-K ANTAGONIST
INTRACRANIAL HEMORRHAGE
ANTITHROMBOTIC THERAPY
CEREBRAL MICROBLEEDS
ATRIAL-FIBRILLATION
RADIOLOGICAL COURSE
HEMATOMA VOLUME
WARFARIN
STROKE
METAANALYSIS
3112 Neurosciences
3124 Neurology and psychiatry
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