Titre :

Recanalization therapies in acute ischemic stroke patients impact of prior treatment with novel oral anticoagulants on bleeding complications and outcome a pilot study

Auteur(s) :

Seiffge, David J. [Auteur]
Hooff, Robbert-Janvan [Auteur]
Nolte, Christian H. [Auteur]
Bejot, Yannick [Auteur]
Turc, Guillaume [Auteur]
Ikenberg, Benno [Auteur]
Berge, Eivind [Auteur]
Persike, Malte [Auteur]
Dequatre-Ponchelle, Nelly [Auteur]
Strbian, Daniel [Auteur]
Pfeilschifter, Waltraud [Auteur]
Zini, Andrea [Auteur]
Tveiten, Arnstein [Auteur]
Naess, Halvor [Auteur]
Michel, Patrik [Auteur]
Sztajzel, Roman [Auteur]
Luft, Andreas [Auteur]
Gensicke, Henrik [Auteur]
Traenka, Christopher [Auteur]
Hert, Lisa [Auteur]
Scheitz, Jan F. [Auteur]
De Marchis, Gian Marco [Auteur]
Bonati, Leo H. [Auteur]
Peters, Nils [Auteur]
Charidimou, Andreas [Auteur]
Werring, David J. [Auteur]
Palm, Frederick [Auteur]
Reinhard, Matthias [Auteur]
Niesen, Wolf-Dirk [Auteur]
Nagao, Takehiko [Auteur]
Pezzini, Alessandro [Auteur]
Caso, Valeria [Auteur]
Nederkoorn, Paul J. [Auteur]
Kagi, Georg [Auteur]
Von Hessling, Alexander [Auteur]
Padjen, Visnja [Auteur]
Cordonnier, Charlotte [Auteur]
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]
Troubles cognitifs dégénératifs et vasculaires - U1171
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]
Erdur, Hebun [Auteur]
Lyrer, Philippe A. [Auteur]
Brouns, Raf [Auteur]
Steiner, Thorsten [Auteur]
Tatlisumak, Turgut [Auteur]
Engelter, Stefan T. [Auteur]

Titre de la revue :

Circulation

Nom court de la revue :

Circulation

Numéro :

132

Pagination :

1261-1269

Date de publication :

2015-09-29

ISSN :

0009-7322

Mot(s)-clé(s) en anglais :

endovascular procedures
anticoagulants
intra-arterial treatment
intracranial hemorrhages
ischemic stroke
non-vitamin K antagonist oral anticoagulants
thrombolytic therapy
vitamin K antagonists

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

BACKGROUND: We explored the safety of intravenous thrombolysis (IVT) or intra-arterial treatment (IAT) in patients with ischemic stroke on non-vitamin K antagonist oral anticoagulants (NOACs, last intake <48 hours) in ...
Lire la suite >BACKGROUND: We explored the safety of intravenous thrombolysis (IVT) or intra-arterial treatment (IAT) in patients with ischemic stroke on non-vitamin K antagonist oral anticoagulants (NOACs, last intake <48 hours) in comparison with patients (1) taking vitamin K antagonists (VKAs) or (2) without previous anticoagulation (no-OAC). RESULTS: This is a multicenter cohort pilot study. Primary outcome measures were (1) occurrence of intracranial hemorrhage (ICH) in 3 categories: any ICH (ICHany), symptomatic ICH according to the criteria of the European Cooperative Acute Stroke Study II (ECASS-II) (sICHECASS-II) and the National Institute of Neurological Disorders and Stroke (NINDS) thrombolysis trial (sICHNINDS); and (2) death (at 3 months). Cohorts were compared by using propensity score matching. Our NOAC cohort comprised 78 patients treated with IVT/IAT and the comparison groups of 441 VKA patients and 8938 no-OAC patients. The median time from last NOAC intake to IVT/IAT was 13 hours (interquartile range, 8-22 hours). In VKA patients, median pre-IVT/IAT international normalized ratio was 1.3 (interquartile range, 1.1-1.6). ICHany was observed in 18.4% NOAC patients versus 26.8% in VKA patients and 17.4% in no-OAC patients. sICHECASS-II and sICHNINDS occurred in 2.6%/3.9% NOAC patients, in comparison with 6.5%/9.3% of VKA patients and 5.0%/7.2% of no-OAC patients, respectively. At 3 months, 23.0% of NOAC patients in comparison with 26.9% of VKA patients and 13.9% of no-OAC patients had died. Propensity score matching revealed no statistically significant differences. CONCLUSIONS: IVT/IAT in selected patients with ischemic stroke under NOAC treatment has a safety profile similar to both IVT/IAT in patients on subtherapeutic VKA treatment or in those without previous anticoagulation. However, further prospective studies are needed, including the impact of specific coagulation tests.Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

CHU Lille
CNRS
Inserm
Université de Lille

Collections :

• Lille Neurosciences & Cognition (LilNCog) - U 1172

Équipe(s) de recherche :

Troubles cognitifs dégénératifs et vasculaires

Date de dépôt :

2019-11-27T14:33:36Z