Long-term antithrombotic treatment in intracranial hemorrhage survivors with atrial fibrillation

Beitrag in einer Fachzeitschrift


Details zur Publikation

Autorinnen und Autoren: Korompoki E, Filippidis FT, Nielsen PB, Del Giudice A, Lip GYH, Kuramatsu JB, Huttner H, Fang J, Schulman S, Marti-Fabregas J, Gathier CS, Viswanathan A, Biffi A, Poli D, Weimar C, Malzahn U, Heuschmann P, Veltkamp R
Zeitschrift: Neurology
Jahr der Veröffentlichung: 2017
Band: 89
Heftnummer: 7
Seitenbereich: 687-696
ISSN: 0028-3878
eISSN: 1526-632X


Abstract


To perform a systematic review and meta-analysis of studies reporting recurrent intracranial hemorrhage (ICH) and ischemic stroke (IS) in ICH survivors with atrial fibrillation (AF) during long-term follow-up.A comprehensive literature search including MEDLINE, EMBASE, Cochrane library, clinical trials registry was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We considered studies capturing outcome events (ICH recurrence and IS) for >=3 months and treatment exposure to vitamin K antagonists (VKAs), antiplatelet agents (APAs), or no antithrombotic medication (no-ATM). Corresponding authors provided aggregate data for IS and ICH recurrence rate between 6 weeks after the event and 1 year of follow-up for each treatment exposure. Meta-analyses of pooled rate ratios (RRs) were conducted with the inverse variance method.Seventeen articles met inclusion criteria. Seven observational studies enrolling 2,452 patients were included in the meta-analysis. Pooled RR estimates for IS were lower for VKAs compared to APAs (RR = 0.45, 95% confidence interval [CI] 0.27-0.74, p = 0.002) and no-ATM (RR = 0.47, 95% CI 0.29-0.77, p = 0.002). Pooled RR estimates for ICH recurrence were not significantly increased across treatment groups (VKA vs APA: RR = 1.34, 95% CI 0.79-2.30, p = 0.28; VKA vs no-ATM: RR = 0.93, 95% CI 0.45-1.90, p = 0.84).In observational studies, anticoagulation with VKA is associated with a lower rate of IS than APA or no-ATM without increasing ICH recurrence significantly. A randomized controlled trial is needed to determine the net clinical benefit of anticoagulation in ICH survivors with AF.



FAU-Autorinnen und Autoren / FAU-Herausgeberinnen und Herausgeber

Huttner, Hagen Prof. Dr.
Medizinische Fakultät


Einrichtungen weiterer Autorinnen und Autoren

Aalborg University
Careggi University Hospital / Azienda Ospedaliero Universitaria Careggi
Harvard University
Hospital de la Santa Creu i Sant Pau
Imperial College London / The Imperial College of Science, Technology and Medicine
Institute for Clinical Evaluative Sciences (ICES)
McMaster University
Universitätsklinikum Essen
Universitätsklinikum Würzburg
University Medical Centre Utrecht (UMC Utrecht)


Zitierweisen

APA:
Korompoki, E., Filippidis, F.T., Nielsen, P.B., Del Giudice, A., Lip, G.Y.H., Kuramatsu, J.B.,... Veltkamp, R. (2017). Long-term antithrombotic treatment in intracranial hemorrhage survivors with atrial fibrillation. Neurology, 89(7), 687-696. https://dx.doi.org/10.1212/WNL.0000000000004235

MLA:
Korompoki, Eleni, et al. "Long-term antithrombotic treatment in intracranial hemorrhage survivors with atrial fibrillation." Neurology 89.7 (2017): 687-696.

BibTeX: 

Zuletzt aktualisiert 2018-08-10 um 08:24