Neuroimaging and clinical outcomes of oral anticoagulant associated ICH.
Authors of this article are:
Tsivgoulis G Wilson D Katsanos AH Sargento-Freitas J Marques-Matos C Azevedo E Adachi T von der Brelie C0 Aizawa Y Abe H Tomita H Okumura K Hagii J Seiffge DJ Lioutas VA Traenka C Varelas P Basir G Krogias C Purrucker JC0 Sharma VK Rizos T0 Mikulik R Sobowale OA Barlinn K Sallinen H Goyal N Yeh SJ Karapanayiotides T Wu TY Vadikolias K Ferrigno M0 Hadjigeorgiou G Houben R Giannopoulos S Schreuder FHBM Chang JJ Perry LA Mehdorn M0 Marto JP Pinho J Tanaka J Boulanger M Salman RA Jäger HR0 Shakeshaft C Yakushiji Y Choi PMC Staals J Cordonnier C0 Jeng JS Veltkamp R Dowlatshahi D Engelter ST Parry-Jones AR Meretoja A Mitsias P Alexandrov AV Ambler G Werring DJ.
A summary of the article is shown below:
OBJECTIVE: Whether intracerebral haemorrhage (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.METHODS: 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 multivariable regression analyses adjusted for age, sex, ICH location and intraventricular haemorrhage extension.RESULTS: 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%; HR=0.94, 95%CI: 0.67 to 1.31). However, in multivariable 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 (OR=0.50, 95%CI: 0.30 to 0.84); and smaller baseline haematoma volume (linear regression coefficient=-0.24,95%CI:-0.47 to -0.16). The two groups did not differ in the likelihood of: baseline haematoma volume less than 30cm3 (OR=1.14, 95%CI: 0.81 to 1.62); haematoma expansion (OR=0.97, 95%CI: 0.63 to 1.48); in-hospital mortality (OR=0.73,95%CI: 0.49 to 1.11); functional status at discharge (common OR=0.78, 95%CI: 0.57 to 1.07); or functional status at three months (common OR=1.03, 95%CI: 0.75 to 1.43).INTERPRETATION: Although functional outcome at discharge, one month or three months were comparable after NOAC-ICH and VKA-ICH, patients with NOAC-ICH had smaller baseline haematoma volumes and less severe acute stroke syndromes. This article is protected by copyright. All rights reserved.This article is protected by copyright. All rights reserved.
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This article is a good source of information and a good way to become familiar with topics such as: haematoma volume;individual patient data meta-analysis;intracerebral haemorrhage;non-vitamin K antagonist;outcome;vitamin K antagonist.
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