|
KMID : 1142120170190010067
|
|
Journal of Stroke
2017 Volume.19 No. 1 p.67 ~ p.76
|
|
|
Haemorrhagic Transformation after Ischaemic Stroke in Patients Taking Non-vitamin K Antagonist Oral Anticoagulants
|
|
Purrucker Jan C.
Haas Kirsten
Wolf Marcel
Rizos Timolaos
Khan Shujah
Kraft Peter
Poli Sven
Dziewas Rainer
Meyne Johannes
Palm Frederick
Jander Sebastian
Mohlenbruch Markus
Heuschmann Peter U.
Veltkamp Roland
|
|
|
Abstract
|
|
|
Background and Purpose: To evaluate the frequency and outcome of haemorrhagic transformation (HT) after ischaemic stroke in patients treated with non-vitamin K antagonist oral anticoagulants (NOACs).
Methods: Patients with stroke on treatment with a NOAC were prospectively enrolled in this multicentre observational study between February 2012 and 2015. Brain imaging at admission and follow-up imaging until day 7 were reviewed for HT. Functional outcome was assessed by the modified Rankin scale (mRS) before the index event, at discharge, and at 3-months.
Results: 231 patients without recanalisation therapy (no-RT), and 32 patients with RT were eligible for analysis. Any HT was present at admission in 9/231 no-RT patients (3.9%, 95% CI 2.0 to 7.3) and in none of the patients with RT. In patients with follow-up imaging (no-RT, n=129, and RT, n=32), HT was present in 14.0% (no-RT; 95% CI, 8.9 to 21.1), and 40.6% (RT, 95% CI, 25.5 to 57.8), respectively. After adjustment for stroke severity, this difference between the no-RT and RT groups became non-significant. Symptomatic ICH was observed in 1 patient per group. HT was not associated with unfavourable outcome (mRS 3-6) at 3-months in multivariable analysis. Resumption of OAC after stroke was delayed in patients with HT compared to those without (15 d [IQR, 5?26] vs. 1 d [0?4], P<0.001).
Conclusions: The frequency and severity of HT after stroke on NOAC appears similar to previous reports for vitamin K antagonists and no anticoagulation. Whether asymptomatic HT should delay resumption of preventive anticoagulation requires further investigation.
|
|
|
KEYWORD
|
|
|
Stroke, Anticoagulation, Haemorrhagic Transformation
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
   
|
|