Long-term antithrombotic treatment in intracranial hemorrhage survivors with atrial fibrillation
Objective: To perform a systematic review and meta-analysis of studies reporting recurrent intracranial hemorrhage (ICH) and ischemic stroke (IS) in ICH survivors with atrial fibrillation (AF) during long-term follow-up. Methods: A comprehensive literature search including MEDLINE, EMBASE, Cochrane...
| Autores: | , , , , , , , , , , , , , , , , , |
|---|---|
| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2017 |
| País: | España |
| Institución: | Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau) |
| Repositorio: | r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau |
| OAI Identifier: | oai:iibsantpau.fundanetsuite.com:p10454 |
| Acceso en línea: | https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=10454 https://europepmc.org/articles/pmc5562962 |
| Access Level: | acceso abierto |
| Palabra clave: | antithrombocytic agent fibrinolytic agent vitamin K group antagonists and inhibitors atrial fibrillation brain hemorrhage brain ischemia cerebrovascular accident human meta analysis Atrial Fibrillation Brain Ischemia Fibrinolytic Agents Humans Intracranial Hemorrhages Platelet Aggregation Inhibitors Stroke Vitamin K |
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Long-term antithrombotic treatment in intracranial hemorrhage survivors with atrial fibrillationKorompoki E.Filippidis F.T.Nielsen P.B.Del Giudice A.Lip G.Y.H.Kuramatsu J.B.Huttner H.B.Fang J.Schulman S.Martí-Fàbregas J.Gathier C.S.Viswanathan A.Biffi A.Poli D.Weimar C.Malzahn U.Heuschmann P.Veltkamp R.antithrombocytic agentfibrinolytic agentvitamin K groupantagonists and inhibitorsatrial fibrillationbrain hemorrhagebrain ischemiacerebrovascular accidenthumanmeta analysisAtrial FibrillationBrain IschemiaFibrinolytic AgentsHumansIntracranial HemorrhagesPlatelet Aggregation InhibitorsStrokeVitamin KObjective: To perform a systematic review and meta-analysis of studies reporting recurrent intracranial hemorrhage (ICH) and ischemic stroke (IS) in ICH survivors with atrial fibrillation (AF) during long-term follow-up. Methods: A comprehensive literature search including MEDLINE, EMBASE, Cochrane library, clinical trials registry was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We considered studies capturing outcome events (ICH recurrence and IS) for =3 months and treatment exposure to vitamin K antagonists (VKAs), antiplatelet agents (APAs), or no antithrombotic medication (no-ATM). Corresponding authors provided aggregate data for IS and ICH recurrence rate between 6 weeks after the event and 1 year of follow-up for each treatment exposure. Meta-analyses of pooled rate ratios (RRs) were conducted with the inverse variance method. Results: Seventeen articles met inclusion criteria. Seven observational studies enrolling 2,452 patients were included in the meta-analysis. Pooled RR estimates for IS were lower for VKAs compared to APAs (RR = 0.45, 95% confidence interval [CI] 0.27-0.74, p = 0.002) and no-ATM (RR = 0.47, 95% CI 0.29-0.77, p = 0.002). Pooled RR estimates for ICH recurrence were not significantly increased across treatment groups (VKA vs APA: RR = 1.34, 95% CI 0.79-2.30, p = 0.28; VKA vs no-ATM: RR = 0.93, 95% CI 0.45-1.90, p = 0.84). Conclusions: In observational studies, anticoagulation with VKA is associated with a lower rate of IS than APA or no-ATM without increasing ICH recurrence significantly. A randomized controlled trial is needed to determine the net clinical benefit of anticoagulation in ICH survivors with AF. © 2017 American Academy of Neurology.LIPPINCOTT WILLIAMS & WILKINS2017info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=10454https://europepmc.org/articles/pmc5562962NEUROLOGYISSN: 00283878ISSNe: 1526632Xreponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p104542026-06-14T12:41:47Z |
| dc.title.none.fl_str_mv |
Long-term antithrombotic treatment in intracranial hemorrhage survivors with atrial fibrillation |
| title |
Long-term antithrombotic treatment in intracranial hemorrhage survivors with atrial fibrillation |
| spellingShingle |
Long-term antithrombotic treatment in intracranial hemorrhage survivors with atrial fibrillation Korompoki E. antithrombocytic agent fibrinolytic agent vitamin K group antagonists and inhibitors atrial fibrillation brain hemorrhage brain ischemia cerebrovascular accident human meta analysis Atrial Fibrillation Brain Ischemia Fibrinolytic Agents Humans Intracranial Hemorrhages Platelet Aggregation Inhibitors Stroke Vitamin K |
| title_short |
Long-term antithrombotic treatment in intracranial hemorrhage survivors with atrial fibrillation |
| title_full |
Long-term antithrombotic treatment in intracranial hemorrhage survivors with atrial fibrillation |
| title_fullStr |
Long-term antithrombotic treatment in intracranial hemorrhage survivors with atrial fibrillation |
| title_full_unstemmed |
Long-term antithrombotic treatment in intracranial hemorrhage survivors with atrial fibrillation |
| title_sort |
Long-term antithrombotic treatment in intracranial hemorrhage survivors with atrial fibrillation |
| dc.creator.none.fl_str_mv |
Korompoki E. Filippidis F.T. Nielsen P.B. Del Giudice A. Lip G.Y.H. Kuramatsu J.B. Huttner H.B. Fang J. Schulman S. Martí-Fàbregas J. Gathier C.S. Viswanathan A. Biffi A. Poli D. Weimar C. Malzahn U. Heuschmann P. Veltkamp R. |
| author |
Korompoki E. |
| author_facet |
Korompoki E. Filippidis F.T. Nielsen P.B. Del Giudice A. Lip G.Y.H. Kuramatsu J.B. Huttner H.B. Fang J. Schulman S. Martí-Fàbregas J. Gathier C.S. Viswanathan A. Biffi A. Poli D. Weimar C. Malzahn U. Heuschmann P. Veltkamp R. |
| author_role |
author |
| author2 |
Filippidis F.T. Nielsen P.B. Del Giudice A. Lip G.Y.H. Kuramatsu J.B. Huttner H.B. Fang J. Schulman S. Martí-Fàbregas J. Gathier C.S. Viswanathan A. Biffi A. Poli D. Weimar C. Malzahn U. Heuschmann P. Veltkamp R. |
| author2_role |
author author author author author author author author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
antithrombocytic agent fibrinolytic agent vitamin K group antagonists and inhibitors atrial fibrillation brain hemorrhage brain ischemia cerebrovascular accident human meta analysis Atrial Fibrillation Brain Ischemia Fibrinolytic Agents Humans Intracranial Hemorrhages Platelet Aggregation Inhibitors Stroke Vitamin K |
| topic |
antithrombocytic agent fibrinolytic agent vitamin K group antagonists and inhibitors atrial fibrillation brain hemorrhage brain ischemia cerebrovascular accident human meta analysis Atrial Fibrillation Brain Ischemia Fibrinolytic Agents Humans Intracranial Hemorrhages Platelet Aggregation Inhibitors Stroke Vitamin K |
| description |
Objective: To perform a systematic review and meta-analysis of studies reporting recurrent intracranial hemorrhage (ICH) and ischemic stroke (IS) in ICH survivors with atrial fibrillation (AF) during long-term follow-up. Methods: A comprehensive literature search including MEDLINE, EMBASE, Cochrane library, clinical trials registry was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We considered studies capturing outcome events (ICH recurrence and IS) for =3 months and treatment exposure to vitamin K antagonists (VKAs), antiplatelet agents (APAs), or no antithrombotic medication (no-ATM). Corresponding authors provided aggregate data for IS and ICH recurrence rate between 6 weeks after the event and 1 year of follow-up for each treatment exposure. Meta-analyses of pooled rate ratios (RRs) were conducted with the inverse variance method. Results: Seventeen articles met inclusion criteria. Seven observational studies enrolling 2,452 patients were included in the meta-analysis. Pooled RR estimates for IS were lower for VKAs compared to APAs (RR = 0.45, 95% confidence interval [CI] 0.27-0.74, p = 0.002) and no-ATM (RR = 0.47, 95% CI 0.29-0.77, p = 0.002). Pooled RR estimates for ICH recurrence were not significantly increased across treatment groups (VKA vs APA: RR = 1.34, 95% CI 0.79-2.30, p = 0.28; VKA vs no-ATM: RR = 0.93, 95% CI 0.45-1.90, p = 0.84). Conclusions: In observational studies, anticoagulation with VKA is associated with a lower rate of IS than APA or no-ATM without increasing ICH recurrence significantly. A randomized controlled trial is needed to determine the net clinical benefit of anticoagulation in ICH survivors with AF. © 2017 American Academy of Neurology. |
| publishDate |
2017 |
| dc.date.none.fl_str_mv |
2017 |
| dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
| format |
article |
| status_str |
publishedVersion |
| dc.identifier.none.fl_str_mv |
https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=10454 https://europepmc.org/articles/pmc5562962 |
| url |
https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=10454 https://europepmc.org/articles/pmc5562962 |
| dc.language.none.fl_str_mv |
Inglés |
| language_invalid_str_mv |
Inglés |
| dc.rights.none.fl_str_mv |
info:eu-repo/semantics/openAccess |
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openAccess |
| dc.publisher.none.fl_str_mv |
LIPPINCOTT WILLIAMS & WILKINS |
| publisher.none.fl_str_mv |
LIPPINCOTT WILLIAMS & WILKINS |
| dc.source.none.fl_str_mv |
NEUROLOGY ISSN: 00283878 ISSNe: 1526632X reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau) |
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Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau) |
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r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau |
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r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau |
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