What question did this study set out to answer?

To compare intracerebral hemorrhage (ICH) volume and functional clinical outcomes between patients taking non-vitamin K oral anticoagulants (NOACs) and those taking warfarin.

December 31, 2015NeurologyOpen Access

Volume and functional outcome of intracerebral hemorrhage according to oral anticoagulant type

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Why the study?

Does NOAC use compared to warfarin use reduce intracerebral hemorrhage volume and improve clinical outcomes in patients with anticoagulant-associated ICH?

Key Points

To compare intracerebral hemorrhage (ICH) volume and functional clinical outcomes between patients taking non-vitamin K oral anticoagulants (NOACs) and those taking warfarin.
Conducted a multicenter cross-sectional observational study comparing 11 patients with NOAC-associated ICH to 52 patients with warfarin-associated ICH from a cohort of 344 patients.
Measured ICH volume with blinded observers and assessed functional outcome at discharge using the modified Rankin Scale (mRS), adjusting for potential confounders.
Median ICH volume was significantly smaller in the NOAC group at 2.4 mL (IQR 0.3–5.4 mL) compared to 8.9 mL (IQR 4.0–21.3 mL) in the warfarin group (p = 0.0028).
Warfarin use was independently associated with larger cube root ICH volumes on multivariable linear regression adjusting for confounders (coefficient 0.64; 95% CI 0.24 to 1.25; p = 0.042).
Warfarin-associated ICH was associated with higher odds of worse clinical outcome at discharge compared to NOAC-associated ICH (OR 4.46; 95% CI 1.10 to 18.14; p = 0.037).

Structured PICO

Does NOAC use compared to warfarin use reduce intracerebral hemorrhage volume and improve clinical outcomes in patients with anticoagulant-associated ICH?

Population

63 patients with anticoagulant-associated intracerebral hemorrhage (ICH) selected from a broader population of 344 patients

Intervention

Non-vitamin K oral anticoagulants (NOAC)

Comparator

Warfarin

Outcome

Intracerebral hemorrhage (ICH) volume and clinical outcome (modified Rankin Scale score at discharge)hard clinical

In patients with anticoagulant-associated intracerebral hemorrhage, prior use of NOACs is associated with smaller hemorrhage volumes and better functional outcomes at discharge compared to warfarin.

Limitations

Small sample size

Authors

DWDuncan WilsonStroke Association ACAndreas CharidimouUniversité de Tours CSClare ShakeshaftUniversity of London

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Should not yet change anticoagulation choices; leaves open need for prospective confirmation of smaller ICH volumes and better outcomes.

Cite This Study

Wilson et al. (2015) studied this question.

synapsesocial.com/papers/6a7d08baff1a536db837cbeb https://doi.org/10.1212/wnl.0000000000002310

Topics

Anticoagulation in AF

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Volume and functional outcome of intracerebral hemorrhage according to oral anticoagulant type

Key Points

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Topics

Volume and functional outcome of intracerebral hemorrhage according to oral anticoagulant type

Key Points

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider