Document Detail


Prior antiplatelet use does not affect hemorrhage growth or outcome after ICH.
MedLine Citation:
PMID:  19129506     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine whether antiplatelet medication use at onset of intracerebral hemorrhage (ICH) is associated with hemorrhage growth and outcome after spontaneous ICH using a large, prospectively collected database from a recent clinical trial. METHODS: The Cerebral Hemorrhage and NXY-059 Treatment trial was a randomized, placebo-controlled trial of NXY-059 after spontaneous ICH. We analyzed patients in the placebo arm, and correlated antiplatelet medication use at the time of ICH with initial ICH volumes, ICH growth in the first 72 hours, and modified Rankin Score at 90 days. Patients on oral anticoagulation were excluded. RESULTS: There were 282 patients included in this analysis, including 70 (24.8%) who were taking antiplatelet medications at ICH onset. Use of antiplatelet medications at ICH onset had no association with the volume of ICH at presentation, growth of ICH at 72 hours, initial edema volume, or edema growth. In multivariable analysis, there was no association of use of antiplatelet medications with any hemorrhage expansion (relative risk [RR] 0.85 [upper limit of confidence interval (UCI) 1.03], p = 0.16), hemorrhage expansion greater than 33% (RR 0.77 [UCI 1.18], p = 0.32), or clinical outcome at 90 days (odds ratio 0.67, 95% confidence interval 0.39-1.14, p = 0.14). CONCLUSIONS: Use of antiplatelet medications at intracerebral hemorrhage (ICH) onset is not associated with increased hemorrhage volumes, hemorrhage expansion, or clinical outcome at 90 days. These findings suggest that attempts to reverse antiplatelet medications after ICH may not be warranted.
Authors:
L H Sansing; S R Messe; B L Cucchiara; S N Cohen; P D Lyden; S E Kasner;
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural     Date:  2009-01-07
Journal Detail:
Title:  Neurology     Volume:  72     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-04-21     Completed Date:  2009-06-22     Revised Date:  2010-09-22    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1397-402     Citation Subset:  AIM; IM    
Affiliation:
Hospital of the University of Pennsylvania, 3400 Spruce Street, 3 W Gates, Philadelphia, PA 19104, USA. sansingl@uphs.upenn.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Brain / blood supply,  drug effects*,  pathology*
Brain Edema / chemically induced,  pathology,  physiopathology
Causality
Cerebral Hemorrhage / chemically induced*,  pathology*,  physiopathology
Disease Progression
Drug Toxicity
Female
Humans
Iatrogenic Disease / prevention & control
Image Processing, Computer-Assisted
Magnetic Resonance Imaging
Male
Middle Aged
Outcome Assessment (Health Care) / methods
Platelet Aggregation Inhibitors / adverse effects*
Prospective Studies
Tomography, X-Ray Computed
Treatment Outcome
Grant Support
ID/Acronym/Agency:
T32 HL007954-07/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Platelet Aggregation Inhibitors
Comments/Corrections
Comment In:
Neurology. 2010 Feb 9;74(6):526; author reply 526-7   [PMID:  20142623 ]
Neurology. 2009 Apr 21;72(16):1376-7   [PMID:  19129503 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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