| Autor: |
Ian Roberts, David J Werring, Philip M Bath, Thompson G Robinson, Rustam Al-Shahi Salman, Serefnur Ozturk, Nikola Sprigg, Christine Roffe, Zhe Kang Law, Kailash Krishnan, Jason Philip Appleton, Polly Scutt, Robert A Dineen, Timothy J England, Hanne Christensen, Michal Karlinski, Philippe Lyrer, Ann Charlotte Laska, Lisa Jane Woodhouse, Maia Beridze, Juan José Egea Guerrero |
| Jazyk: |
angličtina |
| Rok vydání: |
2023 |
| Předmět: |
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| Zdroj: |
BMJ Neurology Open, Vol 5, Iss 1 (2023) |
| Druh dokumentu: |
article |
| ISSN: |
2632-6140 |
| DOI: |
10.1136/bmjno-2023-000423 |
| Popis: |
Background Tranexamic acid reduced haematoma expansion and early death, but did not improve functional outcome in the tranexamic acid for hyperacute spontaneous intracerebral haemorrhage-2 (TICH-2) trial. In a predefined subgroup, there was a statistically significant interaction between prerandomisation baseline systolic blood pressure (SBP) and the effect of tranexamic acid on functional outcome (p=0.019).Methods TICH-2 was an international prospective double-blind placebo-controlled randomised trial evaluating intravenous tranexamic acid in patients with acute spontaneous intracerebral haemorrhage (ICH). Prerandomisation baseline SBP was split into predefined ≤170 and >170 mm Hg groups. The primary outcome at day 90 was the modified Rankin Scale (mRS), a measure of dependency, analysed using ordinal logistic regression. Haematoma expansion was defined as an increase in haematoma volume of >33% or >6 mL from baseline to 24 hours. Data are OR or common OR (cOR) with 95% CIs, with significance at p170 mm Hg. Tranexamic acid was associated with a favourable shift in mRS at day 90 in those with baseline SBP≤170 mm Hg (cOR 0.73, 95% CI 0.59 to 0.91, p=0.005), but not in those with baseline SBP>170 mm Hg (cOR 1.05, 95% CI 0.85 to 1.30, p=0.63). In those with baseline SBP≤170 mm Hg, tranexamic acid reduced haematoma expansion (OR 0.62, 95% CI 0.47 to 0.82, p=0.001), but not in those with baseline SBP>170 mm Hg (OR 1.02, 95% CI 0.77 to 1.35, p=0.90).Conclusions Tranexamic acid was associated with improved clinical and radiological outcomes in ICH patients with baseline SBP≤170 mm Hg. Further research is needed to establish whether certain subgroups may benefit from tranexamic acid in acute ICH.Trial registration number ISRCTN93732214. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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