Antiplatelet agent use was not associated with an increased risk of recurrent intracerebral hemorrhage in survivors of lobar (HR 0.8; 95% CI 0.3-2.3) or deep hemorrhage (HR 1.2; 95% CI 0.1-14.3).
Cohort (n=207)
No
Does antiplatelet therapy increase the risk of recurrent intracerebral hemorrhage in survivors of primary intracerebral hemorrhage?
Antiplatelet therapy after primary intracerebral hemorrhage does not appear to significantly increase the risk of recurrent hemorrhage.
Effect estimate: HR 0.8 (lobar), HR 1.2 (deep) (95% CI 0.3-2.3 (lobar), 0.1-14.3 (deep))
p-value: p=0.73 (lobar), 0.88 (deep)
BACKGROUND: Survivors of intracerebral hemorrhage are at risk for recurrent intracerebral hemorrhage and ischemic cardiovascular and cerebrovascular disease. OBJECTIVE: To determine whether antiplatelet therapy increases the risk of recurrent intracerebral hemorrhage. METHODS: The authors reviewed data from consecutive survivors of primary intracerebral hemorrhage enrolled in a single-center prospective cohort study. Survivors were followed by telephone interview; recurrent intracerebral hemorrhage and post-index antiplatelet agent use and duration were recorded. Cox proportional hazards models was used with antiplatelet agent exposure as a time-dependent variable to assess the effect of antiplatelet agent use on recurrent intracerebral hemorrhage, stratified by lobar and deep hemispheric location. RESULTS: Recurrent intracerebral hemorrhage was more common in survivors of lobar hemorrhage compared with survivors of deep hemorrhage (cumulative 2-year rate 22% vs 4%; p = 0.007). Antiplatelet agents were prescribed in 22% of intracerebral hemorrhage survivors (27/127 lobar, 19/80 deep hemispheric), most commonly for prevention of ischemic heart disease. Antiplatelet agent use was not associated with intracerebral hemorrhage recurrence in survivors of either lobar hemorrhage (hazard ratio HR 0.8, 95% CI 0.3 to 2.3, p = 0.73) or of deep hemorrhage (HR 1.2, 95% CI 0.1 to 14.3, p = 0.88). CONCLUSION: Antiplatelet agent use is relatively common following intracerebral hemorrhage but did not appear to be associated with a large increased risk of intracerebral hemorrhage recurrence in this observational study.
Viswanathan et al. (Tue,) conducted a cohort in primary intracerebral hemorrhage (n=207). Antiplatelet therapy vs. No antiplatelet therapy was evaluated on recurrent intracerebral hemorrhage (HR 0.8 (lobar), HR 1.2 (deep), 95% CI 0.3-2.3 (lobar), 0.1-14.3 (deep), p=0.73 (lobar), 0.88 (deep)). Antiplatelet agent use was not associated with an increased risk of recurrent intracerebral hemorrhage in survivors of lobar (HR 0.8; 95% CI 0.3-2.3) or deep hemorrhage (HR 1.2; 95% CI 0.1-14.3).