Mortality in patients with intracerebral hemorrhage associated with antiplatelet agents, oral anticoagulants or no antithrombotic therapy
| Autor: | Jan Beyer-Westendorf, Cecilia Becattini, Domenico Consoli, Fulvio Pomero, Alessandro De Vito, Alberto Chiti, Alessia Giossi, Giancarlo Agnelli, Giorgia Manina, Roberta Re, Simone Vanni, Valeria Terruso, Simona Sacco, Laura Franco, Maria Lotti Enrico, Umberto Scoditti, Cinzia Nitti, Francesca Guideri, Maurizio Paciaroni, Roberto Cappelli |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Hematoma Fibrinolytic Agents Internal medicine Antithrombotic Internal Medicine medicine Humans In patient cardiovascular diseases 030212 general & internal medicine Prospective Studies Mortality Prospective cohort study Stroke Cerebral Hemorrhage Retrospective Studies Intracerebral hemorrhage business.industry Mortality rate Antiplatelet agents Anticoagulants Cerebral hemorrhage medicine.disease Population study business Platelet Aggregation Inhibitors |
| Zdroj: | European journal of internal medicine. 75 |
| ISSN: | 1879-0828 |
| Popis: | The association between preceding treatment with antiplatelet agents (APs), vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs) and mortality after intracerebral hemorrhage (ICH) remains unclear. The aim of this multicenter, prospective cohort study was to assess the risk for death after ICH in consecutive patients who were on treatment with APs, VKAs, DOACs, or no antithrombotic agent. The primary outcome was in-hospital death by day 30. ICH volume at admission and volume expansion were centrally assessed. Out of 598 study patients, in-hospital death occurred in 21% of patients who were on treatment with APs, 25% with VKAs, 30% with DOACs, and 13% with no antithrombotics. Crude death rate was higher in patients on antithrombotics as compared to patients receiving no antithrombotic agent. At multivariate analysis, age (HR 1.07; 95% CI 1.04-1.10), previous stroke (HR 1.83; 95% CI 1.14-2.93), GCS ≤8 at admission (HR 6.06; 95% CI 3.16-9.74) and GCS 9-12 (HR 3.38; 95% CI 1.81-6.33) were independent predictors of death. Treatment with APs (HR 1.29; 95% CI 0.61-2.76), VKAs (HR 1.42; 95% CI 0.70-2.88) or DOACs (HR 1.28; 95% CI 0.61-2.73) were not predictors of death in the overall study population, in non-trauma associated ICH as well as when GCS was not included in the model. ICH volume and volume expansion were independent predictors of death. In conclusion, preceding treatment with antithrombotic is associated with the severity of ICH. Age, previous stroke and clinical severity at presentation were independent predictors of in-hospital death in patients with ICH. |
| Databáze: | OpenAIRE |
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