Journal article

Reversal strategies for vitamin K antagonists in acute intracerebral hemorrhage

Adrian R Parry-Jones, Mario Di Napoli, Joshua N Goldstein, Floris HBM Schreuder, Sami Tetri, Turgut Tatlisumak, Bernard Yan, Koen M van Nieuwenhuizen, Nelly Dequatre-Ponchelle, Matthew Lee-Archer, Solveig Horstmann, Duncan Wilson, Fulvio Pomero, Luca Masotti, Christine Lerpiniere, Daniel Agustin Godoy, Abigail S Cohen, Rik Houben, Rustam Al-Shahi Salman, Paolo Pennati Show all

ANNALS OF NEUROLOGY | WILEY | Published : 2015

Abstract

OBJECTIVE: There is little evidence to guide treatment strategies for intracerebral hemorrhage on vitamin K antagonists (VKA-ICH). Treatments utilized in clinical practice include fresh frozen plasma (FFP) and prothrombin complex concentrate (PCC). Our aim was to compare case fatality with different reversal strategies. METHODS: We pooled individual ICH patient data from 16 stroke registries in 9 countries (n = 10 282), of whom 1,797 (17%) were on VKA. After excluding 250 patients with international normalized ratio < 1.3 and/or missing data required for analysis, we compared all-cause 30-day case fatality using Cox regression. RESULTS: We included 1,547 patients treated with FFP (n = 377, 2..

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Grants

Awarded by Dutch Heart Foundation


Awarded by ASPASIA grant from the Netherlands Organization for Health Research and Development


Awarded by NIH National Institute of Neurological Disorders and Stroke


Awarded by NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE


Awarded by Medical Research Council


Awarded by Stroke Association


Funding Acknowledgements

This study was supported by the University of Manchester (A.R.P.-J.), the Salford Royal NHS Foundation Trust (A.R.P.-J.), the Academy of Medical Sciences (A.R.P.-J.), the Dowager Countess Eleanor Peel Trust (A.R.P.-J.), the Natalie Kate Moss Trust (A.R.P.-J.), the Italian National Health Service (M.D.N.), a grant from the Helsinki University Central Hospital for research on intracerebral hemorrhage (T.T.), a clinical established investigator grant from the Dutch Heart Foundation (2012T077, C.J.M.K.), an ASPASIA grant from the Netherlands Organization for Health Research and Development (015008048, C.J.M.K.), the Finnish Brain Foundation (J.H.), the Finnish Medical Foundation (J.H., A.M.), the NIH National Institute of Neurological Disorders and Stroke (R01 NS059727, J.R.), the Academy of Finland (A.M.), and the National Health and Medical Research Council (Australia; A.M.). CROMIS-2 was funded by a grant from the British Heart Foundation and the Stroke Association (UK; chief investigator: D.We.). LATCH was funded by an MRC senior clinical fellowship (R.A.-S.S.) and an MRC/Stroke Association clinical research training fellowship.