Epidemiology of Intracranial Hemorrhage Associated with Oral Anticoagulants in Spain: Trends in Anticoagulation Complications Registry – The TAC 2 Study
| Autor: | Jaime Masjuan Vallejo, Álvaro Ximénez-Carrillo Rico, Francisco Moniche, José Maciñeiras, José Vivancos, Jose Antonio Egido, Sonia Quintas, Gustavo Zapata-Wainberg, Lorena Benavente Fernández, Mar Castellanos Rodrigo, María del Mar Freijó Guerrero, Pere Cardona, Joaquín Serena, Andrés García Pastor |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Intracranial hemorrhage 030204 cardiovascular system & hematology Direct oral anticoagulants 03 medical and health sciences 0302 clinical medicine Modified Rankin Scale Internal medicine Antithrombotic Epidemiology medicine Neuroepidemiology cardiovascular diseases Stroke Original Paper business.industry Incidence Incidence (epidemiology) Retrospective cohort study medicine.disease Oral anticoagulants nervous system diseases Vitamin K antagonists Population study Surgery Neurology (clinical) Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery |
| Zdroj: | Repositorio Institucional de la Consejería de Sanidad de la Comunidad de Madrid Consejería de Sanidad de la Comunidad de Madrid |
| ISSN: | 1664-5545 1664-9737 |
| DOI: | 10.1159/000487518 |
| Popis: | Objective: Patients receiving treatment with oral anticoagulants (OACs) are at risk of intracranial hemorrhage (ICH). In this study, we describe the epidemiological and clinical characteristics of patients receiving OACs who experience ICH and compare those receiving vitamin K antagonists (ICH-VKAs) with those receiving direct OACs (ICH-DOACs). Methods: We performed a national, multicenter, descriptive, observational, retrospective study of all adult patients receiving OACs who were admitted to the neurology department with ICH over a 1-year period. The study population was divided into 2 groups (ICH-VKAs and ICH-DOACs). Epidemiological, clinical, radiological, and therapy-related variables, as well as functional outcome, were compared at 3 months. A total of 366 cases were included (331 ICH-VKAs, 35 ICH- DOACs). Results: The crude annual incidence of OAC-induced ICH was 3.8 (95% CI, 2.78–3.41) per 100,000 inhabitants/year. The mean (± SD) age was greater for ICH-DOACs (81.5 ± 8.3 vs. 77.7 ± 8.3 years; p = 0.012). The median (IQR) volume of the hemorrhage was lower for ICH-DOACs (11 [30.8] vs. 25 [50.7] mL; p = 0.03). The functional independence rate at 3 months (modified Rankin Scale, mRS < 3) was similar in both groups, although stroke-related mortality was greater in ICH-VKAs (40 vs. 72.7%; p = 0.02). The most frequently indicated poststroke antithrombotic therapy was DOACs (38.7%). Conclusion: We found that the incidence of OAC-induced ICH was greater than in previous studies. Hemorrhage volume and mortality were lower in ICH-DOACs than in ICH-VKAs. After stroke, DOACs were the most frequently indicated antithrombotic treatment. |
| Databáze: | OpenAIRE |
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