Risk of intracranial hemorrhage (RICH) in users of oral antithrombotic drugs: Nationwide pharmacoepidemiological study

Autor: Heidi Jensberg, Ole Solheim, Sven M. Carlsen, Asgeir Store Jakola, Sasha Gulati, Mattis Aleksander Madsbu, Agnete Malm Gulati, Charalampis Giannadakis, Øyvind Salvesen, Lise Rystad Øie
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Male
European People
Social Sciences
lcsh:Medicine
030204 cardiovascular system & hematology
Pathology and Laboratory Medicine
Antiplatelet Therapy
Vascular Medicine
Drug Users
Geographical Locations
0302 clinical medicine
Rivaroxaban
Risk Factors
Atrial Fibrillation
Antithrombotic
Medicine and Health Sciences
Ethnicities
Psychology
lcsh:Science
Stroke
Aspirin
Multidisciplinary
Pharmaceutics
Norway
Hazard ratio
Middle Aged
Clopidogrel
Hospitals
Addicts
Dabigatran
Europe
Hemorrhagic Stroke
Neurology
Female
Intracranial Hemorrhages
Research Article
medicine.drug
Adult
medicine.medical_specialty
Adolescent
Norwegian People
Cerebrovascular Diseases
Addiction
Hemorrhage
03 medical and health sciences
Signs and Symptoms
Drug Therapy
Fibrinolytic Agents
Diagnostic Medicine
Internal medicine
medicine
Humans
cardiovascular diseases
Aged
business.industry
Pharmacoepidemiology
lcsh:R
Warfarin
Biology and Life Sciences
Anticoagulants
Thrombosis
medicine.disease
Health Care
Health Care Facilities
People and Places
Population Groupings
lcsh:Q
business
030217 neurology & neurosurgery
Zdroj: 13:e0202575
PLoS ONE
PLoS ONE, Vol 13, Iss 8, p e0202575 (2018)
Popis: Background The risks of intracranial haemorrhage (ICH) associated with antithrombotic drugs outside clinical trials are gaining increased attention. The aim of this nationwide study was to investigate the risk of ICH requiring hospital admission in users of antithrombotic drugs. Methods and findings Data from the Norwegian Patient Registry and Norwegian Prescription Database were linked on an individual level. The primary outcome was incidence rates of ICH associated with use of antithrombotic drugs. Secondary endpoints were risk of ICH and fatal outcome following ICH assessed by Cox models. Among 3,131,270 individuals ≥18 years old observed from 2008 through 2014, there were 729,818 users of antithrombotic medications and 22,111 ICH hospitalizations. Annual crude ICH rates per 100 person-years were 0.076 (95% CI, 0.075–0.077) in non-users and 0.30 (95% CI, 0.30–0.31) in users of antithrombotic medication, with the highest age and sex adjusted rates observed for aspirin-dipyridamole plus clopidogrel (0.44; 95% CI, 0.19–0.69), rivaroxaban plus aspirin (0.36; 95% CI, 0.16–0.56), warfarin plus aspirin (0.34; 95% CI, 0.26–0.43), and warfarin plus aspirin and clopidogrel (0.33; 95% CI, 0.073–0.60). With no antithrombotic medication as reference, the highest adjusted hazard ratios (HR) for ICH were observed for aspirin-dypiridamole plus clopidogrel (6.29; 95% CI 3.71–10.7), warfarin plus aspirin and clopidogrel (4.38; 95% CI 2.71–7.09), rivaroxaban plus aspirin (3.82; 95% CI, 2.46–5.95), and warfarin plus aspirin (3.40; 95% CI, 2.99–3.86). All antithrombotic medication regimens were associated with an increased risk of ICH, except dabigatran monotherapy (HR 1.20; 95% CI, 0.88–1.65) and dabigatran plus aspirin (HR 1.79; 95% CI, 0.96–3.34). Fatal outcome within 90 days was more common in users (2,603 of 8,055) than non-users (3,228 of 14,056) of antithrombotic medication (32.3% vs 23.0%, p
Databáze: OpenAIRE
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