Neuroimaging and clinical outcomes of oral anticoagulant –associated intracerebral hemorrhage

ObjectiveWhether intracerebral hemorrhage (ICH) associated with non –vitamin K antagonist oral anticoagulants (NOAC‐ICH) has a better outcome compared to ICH associated with vitamin K antagonists (VKA‐ICH) is uncertain.MethodsWe performed a systematic review and individual patient data meta ‐analysis of cohort studies comparing clinical and radiological outcomes between NOAC‐ICH and VKA‐ICH patients. The primary outcome measure was 30‐day all‐cause mortality. All outcomes were assessed in multivariate regression analyses adjusted for age, sex, ICH location, and intraventricul ar hemorrhage extension.ResultsWe included 7 eligible studies comprising 219 NOAC ‐ICH and 831 VKA‐ICH patients (mean age = 77 years, 52.5% females). The 30‐day mortality was similar between NOAC‐ICH and VKA‐ICH (24.3% vs 26.5%; hazard ratio = 0.94, 95% confidence interval [CI] = 0.67–1.31). However, in multivariate analyses adjusting for potential confounde rs, NOAC‐ICH was associated with lower admission National Institutes of Health Stroke Scale (NIHSS) score (linear regression coefficient = −2.83, 95% CI = −5.28 to −0.38), lower likelihood of severe stroke (NIHSS >  10 points) on admission (odds ratio [OR] = 0.50, 95% CI = 0.30–0.84), and smaller baseline hematoma volume (linear regression coefficient = −0.24, 95% CI = −0.47 to −0.16). The two groups did not differ in the likelihood of baseline hematoma volume <...

Source: Annals of Neurology - October 25, 2018 Category: Neurology Authors: Georgios Tsivgoulis, Duncan Wilson, Aristeidis H. Katsanos, Jo ão Sargento‐Freitas, Cláudia Marques‐Matos, Elsa Azevedo, Tomohide Adachi, Christian Brelie, Yoshifusa Aizawa, Hiroshi Abe, Hirofumi Tomita, Ken Okumura, Joji Hagii, David J Tags: Research Article Source Type: research