Key result
DOAC under-dosing before intracerebral hemorrhage was associated with a higher rate of good functional outcome (40%) compared to optimal or overdosing, though the difference was not significant.
Why the study?
Does the prior dosing of direct oral anticoagulants (optimal, under-dose, or overdose) affect intracerebral hemorrhage severity and functional outcomes in patients with nonvalvular atrial fibrillation?
Observational (n=43)
Does the prior dosing of direct oral anticoagulants (optimal, under-dose, or overdose) affect intracerebral hemorrhage severity and functional outcomes in patients with nonvalvular atrial fibrillation?
Answers are grounded in this paper and cite their sources.
In patients with DOAC-associated intracerebral hemorrhage, prior DOAC overdosing is associated with greater hemorrhage severity and poorer functional outcomes, whereas under-dosing may be associated with better functional outcomes.
OBJECTIVES: The effect of a direct-acting oral anticoagulant (DOAC) dose on intracerebral hemorrhage (ICH) severity and outcome remains unclear. The aim of this study is to clarify the frequency of off-label dosing of DOAC treatments in ICH patients and compare clinical characteristics. PATIENTS AND METHODS: We studied 43 patients with ICH who were treated with DOAC for nonvalvular atrial fibrillation before the onset of ICH. DOAC treatments were categorized into three groups based on the following doses: optimal dose, under-dose, and overdose. ICH severity measured using the National Institutes of Health Stroke Scale scores was the highest in the overdose group (median, 26.5) and the lowest in the under-dose group (median, 6.5) (p = 0.244). Larger initial hematoma volume was observed in the overdose group. The ratio of good outcome (modified Rankin Scale score ≤ 2) was higher in the under-dose group (40%) than the other groups, but this difference was not significant. CONCLUSION: Our study shows only a few patients received overdosing of a DOAC before the onset of ICH, and they were associated with poorer functional outcomes. Conversely, under-dosing was associated with better functional outcomes than the other groups.
No takes yet. Share an insight, caveat, or question.
Suzuki et al. (2018) conducted an observational in Intracerebral hemorrhage with nonvalvular atrial fibrillation (n=43). Direct-acting oral anticoagulant (DOAC) vs. Different DOAC dosing categories (optimal, under-dose, overdose) was evaluated on Good functional outcome (modified Rankin Scale score ≤ 2). DOAC under-dosing before intracerebral hemorrhage was associated with a higher rate of good functional outcome (40%) compared to optimal or overdosing, though the difference was not significant.
Synapse has enriched 10 related papers. Consider them for comparative context: