TY - JOUR
T1 - Ultra-early hematoma growth in antithrombotic pretreated patients with intracerebral hemorrhage
AU - Roquer, J.
AU - Vivanco-Hidalgo, R. M.
AU - Capellades, J.
AU - Ois, A.
AU - Cuadrado-Godia, E.
AU - Giralt-Steinhauer, E.
AU - Soriano-Tárraga, C.
AU - Mola-Caminal, M.
AU - Serra-Martínez, M.
AU - Avellaneda-Gómez, C.
AU - Jiménez-Conde, J.
AU - Rodríguez-Campello, A.
N1 - Funding Information:
This study was supported in part by Spain’s Ministry of Health (Ministerio de Sanidad y Consumo, Insti-tuto de Salud Carlos III FEDER, RD16/0019/0002. INVICTUS-PLUS). Elaine M. Lilly, PhD, provided English language assistance.
Publisher Copyright:
© 2017 EAN
PY - 2018/1
Y1 - 2018/1
N2 - Background and purpose: Patients with acute intracerebral hemorrhage (ICH) pretreated with antithrombotic drugs may have increased early hematoma growth, which would increase mortality risk. The effect of antiplatelet (AP) and vitamin K antagonist (VKA) pretreatment on ultra-early hematoma growth (uHG) and its relationship with mortality in patients with acute supratentorial ICH was analyzed. Methods: This is an observational retrospective study of a prospective register of 197 ICH patients with first computed tomography (CT) scan taken <6 h from ICH symptom onset. ICH volume was calculated by the ABC/2 formula and uHG by the baseline ICH volume/onset-to-CT time (ml/h) formula. The uHG analysis took into account the patient's pretreatment (none, AP or VKA) and the relationship between uHG and very-early (first 24 h) and 3-month mortality. Results: In the pretreatment group, 50 (25.4%) patients were treated with AP and 37 (18.8%) with VKA. The median (interquartile range 25–75) uHG was 19.7 ml/h (2.9–44.8) for AP pretreated patients, 16.2 ml/h (5.1–42.5) for VKA pretreated patients and 8.4 ml/h (2.4–21.8) for non-pretreated patients, P = 0.019. The uHG was higher in patients with very-early [42.1 ml/h (20.1–79.6)] and total 3-month mortality [28.0 ml/h (15.8–52.5)] compared with survivors [3.9 ml/h (1.5–10.4)], P < 0.0001. Adjusted by ICH severity and previous functional status, uHG was an independent factor related to very-early (P = 0.028) and total 3-month mortality (P = 0.014). Conclusions: Patients pretreated with antithrombotics have much higher uHG, which would explain the increased mortality in these patients compared to untreated patients.
AB - Background and purpose: Patients with acute intracerebral hemorrhage (ICH) pretreated with antithrombotic drugs may have increased early hematoma growth, which would increase mortality risk. The effect of antiplatelet (AP) and vitamin K antagonist (VKA) pretreatment on ultra-early hematoma growth (uHG) and its relationship with mortality in patients with acute supratentorial ICH was analyzed. Methods: This is an observational retrospective study of a prospective register of 197 ICH patients with first computed tomography (CT) scan taken <6 h from ICH symptom onset. ICH volume was calculated by the ABC/2 formula and uHG by the baseline ICH volume/onset-to-CT time (ml/h) formula. The uHG analysis took into account the patient's pretreatment (none, AP or VKA) and the relationship between uHG and very-early (first 24 h) and 3-month mortality. Results: In the pretreatment group, 50 (25.4%) patients were treated with AP and 37 (18.8%) with VKA. The median (interquartile range 25–75) uHG was 19.7 ml/h (2.9–44.8) for AP pretreated patients, 16.2 ml/h (5.1–42.5) for VKA pretreated patients and 8.4 ml/h (2.4–21.8) for non-pretreated patients, P = 0.019. The uHG was higher in patients with very-early [42.1 ml/h (20.1–79.6)] and total 3-month mortality [28.0 ml/h (15.8–52.5)] compared with survivors [3.9 ml/h (1.5–10.4)], P < 0.0001. Adjusted by ICH severity and previous functional status, uHG was an independent factor related to very-early (P = 0.028) and total 3-month mortality (P = 0.014). Conclusions: Patients pretreated with antithrombotics have much higher uHG, which would explain the increased mortality in these patients compared to untreated patients.
KW - anticoagulant drugs
KW - antiplatelet agents
KW - cerebral hemorrhage
KW - mortality
KW - prognosis
UR - http://www.scopus.com/inward/record.url?scp=85031702806&partnerID=8YFLogxK
U2 - 10.1111/ene.13458
DO - 10.1111/ene.13458
M3 - Article
C2 - 28906578
AN - SCOPUS:85031702806
VL - 25
SP - 83
EP - 89
JO - European Journal of Neurology
JF - European Journal of Neurology
SN - 1351-5101
IS - 1
ER -