%0 Journal Article
%@ 1531-8249
%A Tsivgoulis, G
%A Wilson, D
%A Katsanos, AH
%A Sargento-Freitas, J
%A Marques-Matos, C
%A Azevedo, E
%A Adachi, T
%A von der Brelie, C
%A Aizawa, Y
%A Abe, H
%A Tomita, H
%A Okumura, K
%A Hagii, J
%A Seiffge, DJ
%A Lioutas, V-A
%A Traenka, C
%A Varelas, P
%A Basir, G
%A Krogias, C
%A Purrucker, JC
%A Sharma, VK
%A Rizos, T
%A Mikulik, R
%A Sobowale, OA
%A Barlinn, K
%A Sallinen, H
%A Goyal, N
%A Yeh, S-J
%A Karapanayiotides, T
%A Wu, TY
%A Vadikolias, K
%A Ferrigno, M
%A Hadjigeorgiou, G
%A Houben, R
%A Giannopoulos, S
%A Schreuder, FHBM
%A Chang, JJ
%A Perry, LA
%A Mehdorn, M
%A Marto, J-P
%A Pinho, J
%A Tanaka, J
%A Boulanger, M
%A Salman, RA-S
%A Jäger, HR
%A Shakeshaft, C
%A Yakushiji, Y
%A Choi, PMC
%A Staals, J
%A Cordonnier, C
%A Jeng, J-S
%A Veltkamp, R
%A Dowlatshahi, D
%A Engelter, ST
%A Parry-Jones, AR
%A Meretoja, A
%A Mitsias, P
%A Alexandrov, AV
%A Ambler, G
%A Werring, DJ
%D 2018
%F discovery:10057877
%J Annals of Neurology
%K haematoma volume, individual patient data meta-analysis, intracerebral haemorrhage, non-vitamin K antagonist, outcome, vitamin K antagonist
%N 5
%P 694-704
%T Neuroimaging and clinical outcomes of oral anticoagulant associated ICH
%U https://discovery.ucl.ac.uk/id/eprint/10057877/
%V 84
%X OBJECTIVE: Whether intracerebral haemorrhage (ICH) associated with non-vitamin K antagonist oral anticoagulants (NOAC-ICH) has a better outcome compared to ICH associated with vitamin-K antagonists (VKA-ICH) is uncertain. METHODS: We performed a systematic review and individual patient data meta-analysis of cohort studies comparing clinical and radiological outcomes between NOAC-ICH and VKA-ICH patients. The primary outcome measure was 30-day all-cause mortality. All outcomes were assessed in multivariable regression analyses adjusted for age, sex, ICH location and intraventricular haemorrhage extension. RESULTS: We included 7 eligible studies comprising 219 NOAC-ICH and 831 VKA-ICH patients (mean age:77 years,52.5% females). The 30-day mortality was similar between NOAC-ICH and VKA-ICH (24.3% vs. 26.5%; HR=0.94, 95%CI: 0.67 to 1.31). However, in multivariable analyses adjusting for potential confounders, NOAC-ICH was associated with: lower admission National Institutes of Health Stroke Scale (NIHSS) score (linear regression coefficient=-2.83, 95%CI:-5.28 to -0.38); lower likelihood of severe stroke (NIHSS>10 points) on admission (OR=0.50, 95%CI: 0.30 to 0.84); and smaller baseline haematoma volume (linear regression coefficient=-0.24,95%CI:-0.47 to -0.16). The two groups did not differ in the likelihood of: baseline haematoma volume less than 30cm3 (OR=1.14, 95%CI: 0.81 to 1.62); haematoma expansion (OR=0.97, 95%CI: 0.63 to 1.48); in-hospital mortality (OR=0.73,95%CI: 0.49 to 1.11); functional status at discharge (common OR=0.78, 95%CI: 0.57 to 1.07); or functional status at three months (common OR=1.03, 95%CI: 0.75 to 1.43). INTERPRETATION: Although functional outcome at discharge, one month or three months were comparable after NOAC-ICH and VKA-ICH, patients with NOAC-ICH had smaller baseline haematoma volumes and less severe acute stroke syndromes.
%Z This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.