eprintid: 10057877 rev_number: 27 eprint_status: archive userid: 608 dir: disk0/10/05/78/77 datestamp: 2018-10-09 07:26:00 lastmod: 2021-12-13 03:12:59 status_changed: 2018-10-09 07:26:00 type: article metadata_visibility: show creators_name: Tsivgoulis, G creators_name: Wilson, D creators_name: Katsanos, AH creators_name: Sargento-Freitas, J creators_name: Marques-Matos, C creators_name: Azevedo, E creators_name: Adachi, T creators_name: von der Brelie, C creators_name: Aizawa, Y creators_name: Abe, H creators_name: Tomita, H creators_name: Okumura, K creators_name: Hagii, J creators_name: Seiffge, DJ creators_name: Lioutas, V-A creators_name: Traenka, C creators_name: Varelas, P creators_name: Basir, G creators_name: Krogias, C creators_name: Purrucker, JC creators_name: Sharma, VK creators_name: Rizos, T creators_name: Mikulik, R creators_name: Sobowale, OA creators_name: Barlinn, K creators_name: Sallinen, H creators_name: Goyal, N creators_name: Yeh, S-J creators_name: Karapanayiotides, T creators_name: Wu, TY creators_name: Vadikolias, K creators_name: Ferrigno, M creators_name: Hadjigeorgiou, G creators_name: Houben, R creators_name: Giannopoulos, S creators_name: Schreuder, FHBM creators_name: Chang, JJ creators_name: Perry, LA creators_name: Mehdorn, M creators_name: Marto, J-P creators_name: Pinho, J creators_name: Tanaka, J creators_name: Boulanger, M creators_name: Salman, RA-S creators_name: Jäger, HR creators_name: Shakeshaft, C creators_name: Yakushiji, Y creators_name: Choi, PMC creators_name: Staals, J creators_name: Cordonnier, C creators_name: Jeng, J-S creators_name: Veltkamp, R creators_name: Dowlatshahi, D creators_name: Engelter, ST creators_name: Parry-Jones, AR creators_name: Meretoja, A creators_name: Mitsias, P creators_name: Alexandrov, AV creators_name: Ambler, G creators_name: Werring, DJ title: Neuroimaging and clinical outcomes of oral anticoagulant associated ICH ispublished: pub subjects: UCH divisions: UCL divisions: B02 divisions: C07 divisions: D07 divisions: F82 divisions: D65 divisions: J38 divisions: B04 divisions: C06 divisions: F61 keywords: haematoma volume, individual patient data meta-analysis, intracerebral haemorrhage, non-vitamin K antagonist, outcome, vitamin K antagonist note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. abstract: 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. date: 2018-11 date_type: published official_url: https://doi.org/10.1002/ana.25342 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1590284 doi: 10.1002/ana.25342 lyricists_name: Ambler, Gareth lyricists_name: Jager, Hans lyricists_name: Shakeshaft, Clare lyricists_name: Werring, David lyricists_id: GAMBL30 lyricists_id: HRJAG57 lyricists_id: CESHA55 lyricists_id: DJWER24 actors_name: Werring, David actors_id: DJWER24 actors_role: owner full_text_status: public publication: Annals of Neurology volume: 84 number: 5 pagerange: 694-704 event_location: United States issn: 1531-8249 citation: Tsivgoulis, G; Wilson, D; Katsanos, AH; Sargento-Freitas, J; Marques-Matos, C; Azevedo, E; Adachi, T; ... Werring, DJ; + view all <#> Tsivgoulis, G; Wilson, D; Katsanos, AH; Sargento-Freitas, J; Marques-Matos, C; Azevedo, E; Adachi, T; von der Brelie, C; Aizawa, Y; Abe, H; Tomita, H; Okumura, K; Hagii, J; Seiffge, DJ; Lioutas, V-A; Traenka, C; Varelas, P; Basir, G; Krogias, C; Purrucker, JC; Sharma, VK; Rizos, T; Mikulik, R; Sobowale, OA; Barlinn, K; Sallinen, H; Goyal, N; Yeh, S-J; Karapanayiotides, T; Wu, TY; Vadikolias, K; Ferrigno, M; Hadjigeorgiou, G; Houben, R; Giannopoulos, S; Schreuder, FHBM; Chang, JJ; Perry, LA; Mehdorn, M; Marto, J-P; Pinho, J; Tanaka, J; Boulanger, M; Salman, RA-S; Jäger, HR; Shakeshaft, C; Yakushiji, Y; Choi, PMC; Staals, J; Cordonnier, C; Jeng, J-S; Veltkamp, R; Dowlatshahi, D; Engelter, ST; Parry-Jones, AR; Meretoja, A; Mitsias, P; Alexandrov, AV; Ambler, G; Werring, DJ; - view fewer <#> (2018) Neuroimaging and clinical outcomes of oral anticoagulant associated ICH. Annals of Neurology , 84 (5) pp. 694-704. 10.1002/ana.25342 <https://doi.org/10.1002/ana.25342>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10057877/1/ana.25342.pdf