Haematoma expansion and mortality in intracerebral haemorrhage after OAC

Results of a meta-analysis show that in patients with intracerebral haemorrhage (ICH), use of vitamin K antagonists (VKA) leads to larger haematoma volume, increased rate of secondary haematoma expansion (HE), and higher mortality compared with non-vitamin K antagonist oral anticoagulants (NOACs) or not using oral anticoagulants (non-OACs) [1].

In this systematic review and meta-analysis, a total of 19 studies with data on 16,546 ICH patients using VKA and 128,561 ICH patients using non-OACs were included; moreover, 2 studies reported data on 4,943 ICH patients using NOACs.

Results showed that haematoma volume was significantly larger in VKA-users (mean difference vs non-OACs-users of +9.66 mL; P<0.001) and HE occurred significantly more often in VKA-users than in non-OACs-users (OR 2.96; 95% CI 1.74-4.97; P<0.001). The risk of in-hospital mortality (OR 1.83, 95% CI 1.61-2.07; P<0.001) and 3-months mortality (OR 2.24; 95% CI 1.52-3.31; P<0.001) was also elevated in VKA-users. There was insufficient data available for the comparison between NOACs-users and non-OACs-users, to determine if NOACs have similar effects.

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   1. Goeldlin M, et al. EAN 2019, O2201.

 



Posted on 27 August 201929 February 2024