Abstract:
:Background and Purpose- Given inconclusive studies, it is debated whether clinical and imaging characteristics, as well as functional outcome, differ among patients with intracerebral hemorrhage (ICH) related to vitamin K antagonists (VKA) versus non-vitamin K antagonist (NOAC)-related ICH. Notably, clinical characteristics according to different NOAC agents and dosages are not established. Methods- Multicenter observational cohort study integrating individual patient data of 1328 patients with oral anticoagulation-associated ICH, including 190 NOAC-related ICH patients, recruited from 2011 to 2015 at 19 tertiary centers across Germany. Imaging, clinical characteristics, and 3-months modified Rankin Scale (mRS) outcomes were compared in NOAC- versus VKA-related ICH patients. Propensity score matching was conducted to adjust for clinically relevant differences in baseline parameters. Subgroup analyses were performed regarding NOAC agent, dosing and present clinically relevant anticoagulatory activity (last intake <12h/24h or NOAC level >30 ng/mL). Results- Despite older age in NOAC patients, there were no relevant differences in clinical and hematoma characteristics between NOAC- and VKA-related ICH regarding baseline hematoma volume (median [interquartile range]: NOAC, 14.7 [5.1-42.3] mL versus VKA, 16.4 [5.8-40.6] mL; P=0.33), rate of hematoma expansion (NOAC, 49/146 [33.6%] versus VKA, 235/688 [34.2%]; P=0.89), and the proportion of patients with unfavorable outcome at 3 months (mRS, 4-6: NOAC 126/179 [70.4%] versus VKA 473/682 [69.4%]; P=0.79). Subgroup analyses revealed that NOAC patients with clinically relevant anticoagulatory effect had higher rates of intraventricular hemorrhage (n/N [%]: present 52/109 [47.7%] versus absent 9/35 [25.7%]; P=0.022) and hematoma expansion (present 35/90 [38.9%] versus absent 5/30 [16.7%]; P=0.040), whereas type of NOAC agent or different NOAC-dosing regimens did not result in relevant differences in imaging characteristics or outcome. Conclusions- If effectively anticoagulated, there are no differences in hematoma characteristics and functional outcome among patients with NOAC- or VKA-related ICH. Clinical Trial Registration- URL: https://www.clinicaltrials.gov . Unique identifier: NCT03093233.
journal_name
Strokejournal_title
Strokeauthors
Gerner ST,Kuramatsu JB,Sembill JA,Sprügel MI,Hagen M,Knappe RU,Endres M,Haeusler KG,Sobesky J,Schurig J,Zweynert S,Bauer M,Vajkoczy P,Ringleb PA,Purrucker JC,Rizos T,Volkmann J,Müllges W,Kraft P,Schubert AL,Erbgutdoi
10.1161/STROKEAHA.118.023492subject
Has Abstractpub_date
2019-06-01 00:00:00pages
1392-1402issue
6eissn
0039-2499issn
1524-4628journal_volume
50pub_type
临床试验,杂志文章,多中心研究相关文献
STROKE文献大全abstract::Platelet activating factor, a potent inducer of in vivo platelet activation and thrombosis, has been shown to be excessively active in acute ischemic stroke patients. Therefore, we studied the effect of aspirin/dipyridamole therapy in inhibiting platelet activating factor-induced platelet activation in acute ischemic ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.20.5.609
更新日期:1989-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The neuroprotective role of mild therapeutic hypothermia was established in animal models of cerebral ischemia. Still, several issues, including optimal target temperature, remain unclear. The optimal depth of hypothermia in a rat model of focal cerebral ischemia was investigated. METHODS:Eighty...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.106.475897
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:This work was undertaken to determine to what degree long-term neurofunctional outcome of neonatal hypoxic-ischemic (HI) brain injury in mice correlates with anatomical extent of cerebral damage assessed by magnetic resonance imaging (MRI) and histopathology. METHODS:On postnatal day 7, mice wer...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000137768.25203.df
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Recent Icelandic studies have demonstrated linkage for common forms of stroke to chromosome 5q12 and association between phosphodiesterase4D (PDE4D) and ischemic stroke. Using a candidate region approach, we wanted to test the validity of these findings in a different population from northern Swe...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000174188.04716.8d
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The efficacy and safety of the selective serotonin reuptake inhibitor fluoxetine have rarely been studied in the treatment of poststroke emotional disturbances. METHODS:Stroke patients (152) who had poststroke depression (PSD), emotional incontinence (PSEI), or anger proneness (PSAP) were studie...
journal_title:Stroke
pub_type: 杂志文章,随机对照试验
doi:10.1161/01.STR.0000190892.93663.e2
更新日期:2006-01-01 00:00:00
abstract::Glycosylated hemoglobin concentration (GHb), which is considered an indication of glycemia over the preceding several months, was examined in 50 patients hospitalized for recent stroke or transient ischemic attacks (TIA), and compared to that in several reference populations. Patients with stroke or TIA had GHb (mean ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.13.3.356
更新日期:1982-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Data on long-term outcome after intravenous tissue-type plasminogen activator (tPA) in ischemic stroke are limited. We examined the risk of long-term mortality, recurrent ischemic stroke, and major bleeding, including intracranial and gastrointestinal bleeding, in intravenous tPA-treated patients...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.114.006570
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We evaluated the impact of admission hyperglycemia (HG) on stroke outcome in relation to the timing of reperfusion in patients treated with tissue plasminogen activator (tPA). METHODS:We studied 138 consecutive stroke patients with a documented middle cerebral artery (MCA) occlusion treated with...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000143728.45516.c6
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:We designed a prospective sequential pretreatment and posttreatment MRI study to assess the relation between neuroimaging parameters and clinical outcome in patients treated with intravenous recombinant tissue-type plasminogen activator (rtPA). METHODS:Patients with symptoms of acute hemispheric...
journal_title:Stroke
pub_type: 临床试验,杂志文章
doi:10.1161/01.str.0000053850.64877.af
更新日期:2003-02-01 00:00:00
abstract::Sixteen acceptably randomized studies of anticoagulant therapy after cerebral or retinal ischemia or infarction are reviewed and the results among 1,046 anticoagulated patients and 1,071 controls are analyzed. The following conclusions are derived. 1) Anticoagulant therapy has not been shown to be better than control ...
journal_title:Stroke
pub_type: 临床试验,杂志文章,评审
doi:10.1161/01.str.19.8.1043
更新日期:1988-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Thrombin, heme oxygenase, complement, microglia activation, and leukocyte infiltration are all actively upregulated in intracerebral hemorrhage (ICH). Experimental evidence suggests that all these factors are involved in ICH-induced brain injury. This suggests a scenario whereby ICH actively (thr...
journal_title:Stroke
pub_type: 杂志文章,评审
doi:10.1161/01.STR.0000170701.41507.e1
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:In an inner-London teaching hospital, a randomized trial of "conventional" care versus early discharge to community-based therapy found no significant differences in clinical outcomes between patient groups. This report examines the economic consequences of the alternative strategies. METHODS:On...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.30.4.729
更新日期:1999-04-01 00:00:00
abstract::In children with Moyamoya disease, transient ischemic attacks often occur during hyperventilation, and the frequency of attacks usually decreases with advancing age. To elucidate the mechanism of the attacks, the regional cerebral blood flow was measured during rest and/or hyperventilation in children aged 3-16 with M...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.18.5.906
更新日期:1987-09-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The overall burden of prior infections may contribute to atherosclerosis and stroke risk. We hypothesized that serological evidence of common infections would be associated with carotid plaque thickness in a multiethnic cohort. METHODS:Antibody titers to 5 common infectious microorganisms (ie, C...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.109.571299
更新日期:2010-03-01 00:00:00
abstract::Forty-five patients with symptomatic (20 with transient ischemic attack, 25 with minor stroke) greater than or equal to 75% stenosis of the cervical internal carotid artery had no endarterectomy and received only medical therapy because the surgical risks (severe cardiac disease, chronic obstructive pulmonary disease,...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.19.1.108
更新日期:1988-01-01 00:00:00
abstract::Background and Purpose- Prestroke dependence is an exclusion criterion in most trials of endovascular treatment (EVT) for acute ischemic stroke. Little is known about outcomes after EVT in these patients. We compared outcome and safety of EVT between prestroke-dependent and prestroke-independent patients. Methods- We ...
journal_title:Stroke
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1161/STROKEAHA.118.022352
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Higher plasma total homocysteine (tHcy) levels have been associated with carotid atherosclerosis and cerebral infarction in whites. However, data regarding such associations are limited for Asians. This study examined associations between tHcy levels and severity of carotid atherosclerosis in Jap...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.0000016463.01398.d0
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The aim of this study was to determine the 30-day mortality and morbidity of intracerebral hemorrhage in a large metropolitan population and to determine the most important predictors of 30-day outcome. METHODS:We reviewed the medical records and computed tomographic films for all cases of spont...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.24.7.987
更新日期:1993-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Thrombolytic treatment of stroke carries the risk of hemorrhagic transformation. Therefore, the potential of MRI for prediction of recombinant tissue plasminogen activator (rtPA)-induced bleeding is explored to identify patients in whom rtPA treatment may provoke such complications. METHODS:Spon...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.0000014619.59851.65
更新日期:2002-05-01 00:00:00
abstract::In a consecutive series of 473 patients admitted within 72 hours after a subarachnoid hemorrhage, 91 (19%) had hydrocephalus on the initial computed tomogram. Consciousness was unimpaired in 25 of the 91 (28%). In 11 more patients acute hydrocephalus developed within 1 week after subarachnoid hemorrhage. Thirty-eight ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.20.6.747
更新日期:1989-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Although insulin resistance and hyperinsulinemia play a crucial role in the pathogenesis of atherosclerosis, little is known about their roles in ischemic stroke. The purpose of this study was to clarify whether insulin resistance and hyperinsulinemia are causative factors in the pathogenesis of ...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.27.1.37
更新日期:1996-01-01 00:00:00
abstract::It has been recognized that small intracerebral hemorrhage not uncommonly produced lacunar syndromes. In this study, we examined cases of intracerebral hemorrhage presenting as lacunar syndromes. Of 174 cases with recent intracerebral hemorrhage, 19 presented with a lacunar syndrome: 4 presented with pure motor hemipa...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.16.3.454
更新日期:1985-05-01 00:00:00
abstract::The effects of halothane on intracellular membrane potential (Em) and force development in cat MCA were studied. Halothane (0.07-0.14 mM/1) relaxed isolated MCA which had developed myogenic tone. Measurement of Em showed that halothane depolarized this preparation in a dose-dependent fashion in the face of vessel rela...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.16.4.680
更新日期:1985-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Higher proportions of hemorrhagic stroke and lacunar infarction were reported in rural Japan compared with those in Western countries. We examined the relative proportions of stroke subtypes in an urban Japanese city where westernized lifestyles are more common than in rural areas. METHODS:Strok...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.STR.0000221714.96986.5f
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:To define desirable target low-density lipoprotein (LDL) cholesterol levels for the prevention of stroke recurrence, a post hoc analysis was performed in the J-STARS study (Japan Statin Treatment Against Recurrent Stroke). METHODS:Subjects (n=1578) were divided into groups based on mean value of...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.117.018870
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Noninvasive studies are used with increasing frequency to assess the carotid bifurcation before endarterectomy. Therefore, assessment of their diagnostic accuracies is essential for appropriate patient management. We prospectively evaluate two noninvasive tests, magnetic resonance angiography (MR...
journal_title:Stroke
pub_type: 临床试验,杂志文章
doi:10.1161/01.str.26.10.1753
更新日期:1995-10-01 00:00:00
abstract::The plasma concentrations of protein C, an anticoagulant protein, and fibrinopeptide A were measured in 37 patients with acute hemispheric stroke and in age-matched controls with nonvascular neurologic diseases. In 11 stroke patients who died within 15 days after the onset (nonsurvivors) protein C antigen concentratio...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/01.str.19.5.579
更新日期:1988-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Although the modified Rankin Scale (mRS) is the most commonly used primary end point in acute stroke trials, its power is limited when analyzed in dichotomized fashion and its indication of effect size challenging to interpret when analyzed ordinally. Weighting the 7 Rankin levels by utilities ma...
journal_title:Stroke
pub_type: 杂志文章,meta分析
doi:10.1161/STROKEAHA.114.008547
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Few studies are available that have addressed the prevalence of early-onset dementia (EOD), including early-onset Alzheimer disease and other forms of dementia in Japan. METHODS:A 2-step postal survey was sent to all of the 2475 institutions providing medical or care services for individuals wit...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.108.542308
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Understanding on distinct subsets of endothelial progenitor cells may provide insights of endothelial dysfunction or repair in the acute ischemic event. Recent in vitro data have reported the colony-forming unit (CFU) and outgrowth cell population as a subset of endothelial progenitor cells. In t...
journal_title:Stroke
pub_type: 杂志文章
doi:10.1161/STROKEAHA.107.499236
更新日期:2008-05-01 00:00:00