Trends in prior antithrombotic medication and risk of in-hospital mortality after spontaneous intracerebral hemorrhage: the J-ICH registry.

Autor: Ueno H; Department of Neurosurgery, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka, 410-2295, Japan., Tokugawa J; Department of Neurosurgery, Juntendo University Nerima Hospital, 3-1-10 Takanodai, Nerima, Tokyo, 177-8521, Japan., Saito R; Department of Neurosurgery, Koshigaya Municipal Hospital, 10-47-1 Higashikoshigaya, Koshigaya, Saitama, 343-0023, Japan., Yamashiro K; Department of Neurology, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan., Tsutsumi S; Department of Neurosurgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan., Yamamoto M; Department of Neurosurgery, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo, Tokyo, 113-8421, Japan., Ueno Y; Department of Neurology, University of Yamanashi, 1110, Shimokato, Chuo, Yamanashi, 409-3898, Japan.; Department of Neurology, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo, Tokyo, 113-8421, Japan., Mieno M; Department of Medical Informatics, Center for Information, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan., Yamamoto T; Department of Neurosurgery, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka, 410-2295, Japan., Hishii M; Department of Neurosurgery, Juntendo University Nerima Hospital, 3-1-10 Takanodai, Nerima, Tokyo, 177-8521, Japan., Yasumoto Y; Department of Neurosurgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan., Maruki C; Department of Neurosurgery, Koshigaya Municipal Hospital, 10-47-1 Higashikoshigaya, Koshigaya, Saitama, 343-0023, Japan., Kondo A; Department of Neurosurgery, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo, Tokyo, 113-8421, Japan., Urabe T; Department of Neurology, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan., Hattori N; Department of Neurology, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo, Tokyo, 113-8421, Japan., Arai H; Department of Neurosurgery, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo, Tokyo, 113-8421, Japan., Tanaka R; Department of Neurology, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo, Tokyo, 113-8421, Japan. rtanaka@jichi.ac.jp.; Stroke Center and Division of Neurology, Department of Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. rtanaka@jichi.ac.jp.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2024 May 25; Vol. 14 (1), pp. 12009. Date of Electronic Publication: 2024 May 25.
DOI: 10.1038/s41598-024-62717-5
Abstrakt: Spontaneous intracerebral hemorrhage (SICH) remains a devastating form of stroke. Prior use of antiplatelets or warfarin before SICH is associated with poor outcomes, but the effects of direct oral anticoagulants (DOACs) remain unclear. This study aimed to clarify trends in prior antithrombotic use and to assess the associations between prior use of antithrombotics and in-hospital mortality using a multicenter prospective registry in Japan. In total, 1085 patients were analyzed. Prior antithrombotic medication included antiplatelets in 14.2%, oral anticoagulants in 8.1%, and both in 1.8%. Prior warfarin use was significantly associated with in-hospital mortality (odds ratio [OR] 5.50, 95% confidence interval [CI] 1.30-23.26, P < 0.05) compared to no prior antithrombotic use. No such association was evident between prior DOAC use and no prior antithrombotic use (OR 1.34, 95% CI 0.44-4.05, P = 0.606). Concomitant use of antiplatelets and warfarin further increased the in-hospital mortality rate (37.5%) compared to warfarin alone (17.2%), but no such association was found for antiplatelets plus DOACs (8.3%) compared to DOACs alone (11.9%). Prior use of warfarin remains an independent risk factor for in-hospital mortality after SICH in the era of DOACs. Further strategies are warranted to reduce SICH among patients receiving oral anticoagulants and to prevent serious outcomes.
(© 2024. The Author(s).)
Databáze: MEDLINE
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