Reversal strategies for vitamin k antagonists ...
Type de document :
Article dans une revue scientifique: Article original
DOI :
PMID :
URL permanente :
Titre :
Reversal strategies for vitamin k antagonists in acute intracerebral hemorrhage
Auteur(s) :
Parry-Jones, Adrian R. [Auteur]
Di Napoli, Mario [Auteur]
Goldstein, Joshua N. [Auteur]
Schreuder, Floris H. B. M. [Auteur]
Tetri, Sami [Auteur]
Tatlisumak, Turgut [Auteur]
Yan, Bernard [Auteur]
Van Nieuwenhuizen, Koen M. [Auteur]
Dequatre-Ponchelle, Nelly [Auteur]
Lee-Archer, Matthew [Auteur]
Horstmann, Solveig [Auteur]
Wilson, Duncan [Auteur]
Pomero, Fulvio [Auteur]
Masotti, Luca [Auteur]
Lerpiniere, Christine [Auteur]
Godoy, Daniel Agustin [Auteur]
Cohen, Abigail S. [Auteur]
Houben, Rik [Auteur]
Salman, Rustam Al-Shahi [Auteur]
Pennati, Paolo [Auteur]
Fenoglio, Luigi [Auteur]
Werring, David J. [Auteur]
Veltkamp, Roland [Auteur]
Wood, Edith [Auteur]
Dewey, Helen M. [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]
Klijn, Catharina J. M. [Auteur]
Meligeni, Fabrizio [Auteur]
Davis, Stephen M. [Auteur]
Huhtakangas, Juha [Auteur]
Staals, Julie [Auteur]
Rosand, Jonathan [Auteur]
Meretoja, Atte [Auteur]
Di Napoli, Mario [Auteur]
Goldstein, Joshua N. [Auteur]
Schreuder, Floris H. B. M. [Auteur]
Tetri, Sami [Auteur]
Tatlisumak, Turgut [Auteur]
Yan, Bernard [Auteur]
Van Nieuwenhuizen, Koen M. [Auteur]
Dequatre-Ponchelle, Nelly [Auteur]
Lee-Archer, Matthew [Auteur]
Horstmann, Solveig [Auteur]
Wilson, Duncan [Auteur]
Pomero, Fulvio [Auteur]
Masotti, Luca [Auteur]
Lerpiniere, Christine [Auteur]
Godoy, Daniel Agustin [Auteur]
Cohen, Abigail S. [Auteur]
Houben, Rik [Auteur]
Salman, Rustam Al-Shahi [Auteur]
Pennati, Paolo [Auteur]
Fenoglio, Luigi [Auteur]
Werring, David J. [Auteur]
Veltkamp, Roland [Auteur]
Wood, Edith [Auteur]
Dewey, Helen M. [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]
Klijn, Catharina J. M. [Auteur]
Meligeni, Fabrizio [Auteur]
Davis, Stephen M. [Auteur]
Huhtakangas, Juha [Auteur]
Staals, Julie [Auteur]
Rosand, Jonathan [Auteur]
Meretoja, Atte [Auteur]
Titre de la revue :
Annals of neurology
Nom court de la revue :
Ann. Neurol.
Numéro :
78
Pagination :
54-62
Date de publication :
2015-07-01
ISSN :
0364-5134
Discipline(s) HAL :
Sciences du Vivant [q-bio]
Résumé en anglais : [en]
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 ...
Lire la suite >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, 24%), PCC (n = 585, 38%), both (n = 131, 9%), or neither (n = 454, 29%). The crude case fatality and adjusted hazard ratio (HR) were highest with no reversal (61.7%, HR = 2.540, 95% confidence interval [CI] = 1.784-3.616, p < 0.001), followed by FFP alone (45.6%, HR = 1.344, 95% CI = 0.934-1.934, p = 0.112), then PCC alone (37.3%, HR = 1.445, 95% CI = 1.014-2.058, p = 0.041), compared to reversal with both FFP and PCC (27.8%, reference). Outcomes with PCC versus FFP were similar (HR = 1.075, 95% CI = 0.874-1.323, p = 0.492); 4-factor PCC (n = 441) was associated with higher case fatality compared to 3-factor PCC (n = 144, HR = 1.441, 95% CI = 1.041-1.995, p = 0.027). CONCLUSIONS: The combination of FFP and PCC might be associated with the lowest case fatality in reversal of VKA-ICH, and FFP may be equivalent to PCC. Randomized controlled trials with functional outcomes are needed to establish the most effective treatment.Lire moins >
Lire la suite >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, 24%), PCC (n = 585, 38%), both (n = 131, 9%), or neither (n = 454, 29%). The crude case fatality and adjusted hazard ratio (HR) were highest with no reversal (61.7%, HR = 2.540, 95% confidence interval [CI] = 1.784-3.616, p < 0.001), followed by FFP alone (45.6%, HR = 1.344, 95% CI = 0.934-1.934, p = 0.112), then PCC alone (37.3%, HR = 1.445, 95% CI = 1.014-2.058, p = 0.041), compared to reversal with both FFP and PCC (27.8%, reference). Outcomes with PCC versus FFP were similar (HR = 1.075, 95% CI = 0.874-1.323, p = 0.492); 4-factor PCC (n = 441) was associated with higher case fatality compared to 3-factor PCC (n = 144, HR = 1.441, 95% CI = 1.041-1.995, p = 0.027). CONCLUSIONS: The combination of FFP and PCC might be associated with the lowest case fatality in reversal of VKA-ICH, and FFP may be equivalent to PCC. Randomized controlled trials with functional outcomes are needed to establish the most effective treatment.Lire moins >
Langue :
Anglais
Audience :
Internationale
Vulgarisation :
Non
Établissement(s) :
CHU Lille
CNRS
Inserm
Université de Lille
CNRS
Inserm
Université de Lille
Collections :
Équipe(s) de recherche :
Troubles cognitifs dégénératifs et vasculaires
Date de dépôt :
2019-11-27T14:32:11Z