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Recanalization Ther...
Recanalization Therapies in Acute Ischemic Stroke Patients Impact of Prior Treatment With Novel Oral Anticoagulants on Bleeding Complications and Outcome A Pilot Study
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Seiffge, D. J. (author)
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Hooff, R. J. (author)
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Nolte, C. H. (author)
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show more...
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Bejot, Y. (author)
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Turc, G. (author)
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Ikenberg, B. (author)
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Berge, E. (author)
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Persike, M. (author)
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Dequatre-Ponchelle, N. (author)
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Strbian, D. (author)
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Pfeilschifter, W. (author)
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Zini, A. (author)
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Tveiten, A. (author)
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Naess, H. (author)
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Michel, P. (author)
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Sztajzel, R. (author)
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Luft, A. (author)
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Gensicke, H. (author)
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Traenka, C. (author)
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Hert, L. (author)
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Scheitz, J. F. (author)
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De Marchis, G. M. (author)
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Bonati, L. H. (author)
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Peters, N. (author)
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Charidimou, A. (author)
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Werring, D. J. (author)
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Reinhard, M. (author)
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Niesen, W. D. (author)
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Nagao, T. (author)
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Pezzini, A. (author)
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Caso, V. (author)
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Nederkoorn, P. J. (author)
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Kagi, G. (author)
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von Hessling, A. (author)
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Padjen, V. (author)
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Cordonnier, C. (author)
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Erdur, H. (author)
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Lyrer, P. A. (author)
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Brouns, R. (author)
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Steiner, T. (author)
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- Tatlisumak, Turgut (author)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology
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Engelter, S. T. (author)
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(creator_code:org_t)
- Ovid Technologies (Wolters Kluwer Health), 2015
- 2015
- English.
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In: Circulation. - : Ovid Technologies (Wolters Kluwer Health). - 0009-7322 .- 1524-4539. ; 132:13, s. 1261-1269
- Related links:
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https://iris.unibs.i...
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Subject headings
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- Background-We explored the safety of intravenous thrombolysis (IVT) or intra-arterial treatment (IAT) in patients with ischemic stroke on non-vitamin K antagonist oral anticoagulants (NOACs, last intake <48 hours) in comparison with patients (1) taking vitamin K antagonists (VKAs) or (2) without previous anticoagulation (no-OAC). Methods and Results-This is a multicenter cohort pilot study. Primary outcome measures were (1) occurrence of intracranial hemorrhage (ICH) in 3 categories: any ICH (ICH any), symptomatic ICH according to the criteria of the European Cooperative Acute Stroke Study II (ECASS-II) (sICH ECASS-II) and the National Institute of Neurological Disorders and Stroke (NINDS) thrombolysis trial (sICH NINDS); and (2) death (at 3 months). Cohorts were compared by using propensity score matching. Our NOAC cohort comprised 78 patients treated with IVT/IAT and the comparison groups of 441 VKA patients and 8938 no-OAC patients. The median time from last NOAC intake to IVT/IAT was 13 hours (interquartile range, 8-22 hours). In VKA patients, median pre-IVT/IAT international normalized ratio was 1.3 (interquartile range, 1.1-1.6). ICH any was observed in 18.4% NOAC patients versus 26.8% in VKA patients and 17.4% in no-OAC patients. sICH ECASS-II and sICH NINDS occurred in 2.6%/3.9% NOAC patients, in comparison with 6.5%/9.3% of VKA patients and 5.0%/7.2% of no-OAC patients, respectively. At 3 months, 23.0% of NOAC patients in comparison with 26.9% of VKA patients and 13.9% of no-OAC patients had died. Propensity score matching revealed no statistically significant differences. Conclusions-IVT/IAT in selected patients with ischemic stroke under NOAC treatment has a safety profile similar to both IVT/IAT in patients on subtherapeutic VKA treatment or in those without previous anticoagulation. However, further prospective studies are needed, including the impact of specific coagulation tests.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Neurovetenskaper (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Neurosciences (hsv//eng)
Keyword
- anticoagulants
- endovascular procedures
- intra-arterial treatment
- intracranial hemorrhages
- tissue-plasminogen activator
- intravenous thrombolysis
- intracerebral
- hemorrhage
- intracranial hemorrhage
- atrial-fibrillation
- endovascular
- thrombectomy
- propensity score
- iv thrombolysis
- dabigatran
- management
- Cardiovascular System & Cardiology
Publication and Content Type
- ref (subject category)
- art (subject category)
Find in a library
To the university's database
- By the author/editor
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Seiffge, D. J.
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Hooff, R. J.
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Nolte, C. H.
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Bejot, Y.
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Turc, G.
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Ikenberg, B.
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show more...
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Berge, E.
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Persike, M.
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Dequatre-Ponchel ...
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Strbian, D.
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Pfeilschifter, W ...
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Zini, A.
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Tveiten, A.
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Naess, H.
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Michel, P.
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Sztajzel, R.
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Luft, A.
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Gensicke, H.
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Traenka, C.
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Hert, L.
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Scheitz, J. F.
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De Marchis, G. M ...
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Bonati, L. H.
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Peters, N.
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Charidimou, A.
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Werring, D. J.
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Reinhard, M.
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Niesen, W. D.
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Nagao, T.
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Pezzini, A.
-
Caso, V.
-
Nederkoorn, P. J ...
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Kagi, G.
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von Hessling, A.
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Padjen, V.
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Cordonnier, C.
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Erdur, H.
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Lyrer, P. A.
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Brouns, R.
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Steiner, T.
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Tatlisumak, Turg ...
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Engelter, S. T.
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Basic Medicine
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and Neurosciences
- Articles in the publication
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Circulation
- By the university
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University of Gothenburg