Key result
In matched patients with intracerebral hemorrhage, restarting antiplatelet therapy was not associated with a difference in good functional outcome at 90 days (35.5% vs 43.9%; p=0.105).
Why the study?
Does restarting antiplatelet therapy improve functional outcomes in adult patients surviving an intracerebral hemorrhage?
Cohort (n=859)
Does restarting antiplatelet therapy improve functional outcomes in adult patients surviving an intracerebral hemorrhage?
Absolute Event Rate: 35.5% vs 43.9%
p-value: p=0.105
Restarting antiplatelet therapy after mild to moderate intracerebral hemorrhage does not significantly worsen functional outcomes or quality of life at 90 days.
Objective To compare the functional outcomes and health-related quality of life metrics of restarting vs not restarting antiplatelet therapy (APT) in patients presenting with intracerebral hemorrhage (ICH) in the ERICH (Ethnic/Racial Variations of Intracerebral Hemorrhage) study. Methods Adult patients aged 18 years and older who were on APT before ICH and were alive at hospital discharge were included. Patients were dichotomized based on whether or not APT was restarted after hospital discharge. The primary outcome was a modified Rankin Scale score of 0–2 at 90 days. Secondary outcomes were excellent outcome (modified Rankin Scale score 0–1), mortality, Barthel Index, and health status (EuroQol–5 dimensions [EQ-5D] and EQ-5D visual analog scale scores) at 90 days. Results The APT and no APT cohorts comprised 127 and 732 patients, respectively. Restarting APT was associated with lower rates of good functional outcome (36.5% vs 40.8%; p = 0.021) and lower Barthel Index scores at 90 days (p = 0.041). The 2 cohorts were then matched in a 1:1 ratio, and the matched cohorts each comprised 107 patients. No difference in primary outcome was observed between restarting vs not restarting APT (35.5% vs 43.9%; p = 0.105). There were also no differences between the secondary outcomes of the 2 cohorts. Conclusion Restarting APT in patients with ICH of mild to moderate severity after acute hospitalization is not associated with worse functional outcomes or health-related quality of life at 90 days. In patients with significant cardiovascular risk factors who experience an ICH, restarting APT remains the decision of the treating practitioner.
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Chen et al. (2018) conducted a cohort in Intracerebral hemorrhage (n=859). Restarting antiplatelet therapy vs. Not restarting antiplatelet therapy was evaluated on Modified Rankin Scale score of 0–2 at 90 days (p=0.105). In matched patients with intracerebral hemorrhage, restarting antiplatelet therapy was not associated with a difference in good functional outcome at 90 days (35.5% vs 43.9%; p=0.105).
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