Prior antiplatelet therapy and outcome following intracerebral hemorrhage: a systematic review

B B Thompson; Y Béjot; V Caso; Jaime Castillo; Hanne Krarup Christensen; M L Flaherty; C Foerch; K Ghandehari; M Giroud; S M Greenberg; H Hallevi; J C Hemphill; P Heuschmann; S Juvela; K Kimura; P K Myint; Y Nagakane; H Naritomi; S Passero; M R Rodríguez-Yáñez; J Roquer; J Rosand; N S Rost; P Saloheimo; V Salomaa; J Sivenius; T Sorimachi; M Togha; K Toyoda; W Turaj; K N Vemmos; C D A Wolfe; D Woo; E E Smith

doi:http://dx.doi.org/10.1212/WNL.0b013e3181f735e5

Prior antiplatelet therapy and outcome following intracerebral hemorrhage: a systematic review

B B Thompson, Y Béjot, V Caso, Jaime Castillo, Hanne Krarup Christensen, M L Flaherty, C Foerch, K Ghandehari, M Giroud, S M Greenberg, H Hallevi, J C Hemphill, P Heuschmann, S Juvela, K Kimura, P K Myint, Y Nagakane, H Naritomi, S Passero, M R Rodríguez-YáñezJ Roquer, J Rosand, N S Rost, P Saloheimo, V Salomaa, J Sivenius, T Sorimachi, M Togha, K Toyoda, W Turaj, K N Vemmos, C D A Wolfe, D Woo, E E Smith

114 Citations (Scopus)

Abstract

Objectives:: Antiplatelet therapy (APT) promotes bleeding; therefore, APT might worsen outcome in patients with intracerebral hemorrhage (ICH). We performed a systematic review and meta-analysis to address the hypothesis that pre-ICH APT use is associated with mortality and poor functional outcome following Ich. Methods:: The Medline and Embase databases were searched in February 2008 using relevant key words, limited to human studies in the English language. Cohort studies of consecutive patients with ICH reporting mortality or functional outcome according to pre-ICH APT use were identified. Of 2,873 studies screened, 10 were judged to meet inclusion criteria by consensus of 2 authors. Additionally, we solicited unpublished data from all authors of cohort studies with >100 patients published within the last 10 years, and received data from 15 more studies. Univariate and multivariable-adjusted odds ratios (ORs) for mortality and poor functional outcome were abstracted as available and pooled using a random effects model. Results:: We obtained mortality data from 25 cohorts (15 unpublished) and functional outcome data from 21 cohorts (14 unpublished). Pre-ICH APT users had increased mortality in both univariate (OR 1.41, 95% confidence interval [CI] 1.21 to 1.64) and multivariable-adjusted (OR 1.27, 95% CI 1.10 to 1.47) pooled analyses. By contrast, the pooled OR for poor functional outcome was no longer significant when using multivariable-adjusted estimates (univariate OR 1.29, 95% CI 1.09 to 1.53; multivariable-adjusted OR 1.10, 95% CI 0.93 to 1.29). Conclusions:: In cohort studies, APT use at the time of ICH compared to no APT use was independently associated with increased mortality but not with poor functional outcome.

Original language	English
Journal	Neurology
Volume	75
Issue number	15
Pages (from-to)	1333-42
Number of pages	10
ISSN	0028-3878
DOIs	https://doi.org/10.1212/WNL.0b013e3181f735e5
Publication status	Published - 12 Oct 2010

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Thompson, B. B., Béjot, Y., Caso, V., Castillo, J., Christensen, H. K., Flaherty, M. L., Foerch, C., Ghandehari, K., Giroud, M., Greenberg, S. M., Hallevi, H., Hemphill, J. C., Heuschmann, P., Juvela, S., Kimura, K., Myint, P. K., Nagakane, Y., Naritomi, H., Passero, S., ... Smith, E. E. (2010). Prior antiplatelet therapy and outcome following intracerebral hemorrhage: a systematic review. Neurology, 75(15), 1333-42. https://doi.org/10.1212/WNL.0b013e3181f735e5

Thompson, BB, Béjot, Y, Caso, V, Castillo, J, Christensen, HK, Flaherty, ML, Foerch, C, Ghandehari, K, Giroud, M, Greenberg, SM, Hallevi, H, Hemphill, JC, Heuschmann, P, Juvela, S, Kimura, K, Myint, PK, Nagakane, Y, Naritomi, H, Passero, S, Rodríguez-Yáñez, MR, Roquer, J, Rosand, J, Rost, NS, Saloheimo, P, Salomaa, V, Sivenius, J, Sorimachi, T, Togha, M, Toyoda, K, Turaj, W, Vemmos, KN, Wolfe, CDA, Woo, D & Smith, EE 2010, 'Prior antiplatelet therapy and outcome following intracerebral hemorrhage: a systematic review', Neurology, vol. 75, no. 15, pp. 1333-42. https://doi.org/10.1212/WNL.0b013e3181f735e5

@article{71af61b0ab69490aabdd69b4dceba093,

title = "Prior antiplatelet therapy and outcome following intracerebral hemorrhage: a systematic review",

abstract = "Objectives:: Antiplatelet therapy (APT) promotes bleeding; therefore, APT might worsen outcome in patients with intracerebral hemorrhage (ICH). We performed a systematic review and meta-analysis to address the hypothesis that pre-ICH APT use is associated with mortality and poor functional outcome following Ich. Methods:: The Medline and Embase databases were searched in February 2008 using relevant key words, limited to human studies in the English language. Cohort studies of consecutive patients with ICH reporting mortality or functional outcome according to pre-ICH APT use were identified. Of 2,873 studies screened, 10 were judged to meet inclusion criteria by consensus of 2 authors. Additionally, we solicited unpublished data from all authors of cohort studies with >100 patients published within the last 10 years, and received data from 15 more studies. Univariate and multivariable-adjusted odds ratios (ORs) for mortality and poor functional outcome were abstracted as available and pooled using a random effects model. Results:: We obtained mortality data from 25 cohorts (15 unpublished) and functional outcome data from 21 cohorts (14 unpublished). Pre-ICH APT users had increased mortality in both univariate (OR 1.41, 95% confidence interval [CI] 1.21 to 1.64) and multivariable-adjusted (OR 1.27, 95% CI 1.10 to 1.47) pooled analyses. By contrast, the pooled OR for poor functional outcome was no longer significant when using multivariable-adjusted estimates (univariate OR 1.29, 95% CI 1.09 to 1.53; multivariable-adjusted OR 1.10, 95% CI 0.93 to 1.29). Conclusions:: In cohort studies, APT use at the time of ICH compared to no APT use was independently associated with increased mortality but not with poor functional outcome.",

author = "Thompson, {B B} and Y B{\'e}jot and V Caso and Jaime Castillo and Christensen, {Hanne Krarup} and Flaherty, {M L} and C Foerch and K Ghandehari and M Giroud and Greenberg, {S M} and H Hallevi and Hemphill, {J C} and P Heuschmann and S Juvela and K Kimura and Myint, {P K} and Y Nagakane and H Naritomi and S Passero and Rodr{\'i}guez-Y{\'a}{\~n}ez, {M R} and J Roquer and J Rosand and Rost, {N S} and P Saloheimo and V Salomaa and J Sivenius and T Sorimachi and M Togha and K Toyoda and W Turaj and Vemmos, {K N} and Wolfe, {C D A} and D Woo and Smith, {E E}",

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language = "English",

volume = "75",

pages = "1333--42",

journal = "Neurology",

issn = "0028-3878",

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TY - JOUR

T1 - Prior antiplatelet therapy and outcome following intracerebral hemorrhage: a systematic review

AU - Thompson, B B

AU - Béjot, Y

AU - Caso, V

AU - Castillo, Jaime

AU - Christensen, Hanne Krarup

AU - Flaherty, M L

AU - Foerch, C

AU - Ghandehari, K

AU - Giroud, M

AU - Greenberg, S M

AU - Hallevi, H

AU - Hemphill, J C

AU - Heuschmann, P

AU - Juvela, S

AU - Kimura, K

AU - Myint, P K

AU - Nagakane, Y

AU - Naritomi, H

AU - Passero, S

AU - Rodríguez-Yáñez, M R

AU - Roquer, J

AU - Rosand, J

AU - Rost, N S

AU - Saloheimo, P

AU - Salomaa, V

AU - Sivenius, J

AU - Sorimachi, T

AU - Togha, M

AU - Toyoda, K

AU - Turaj, W

AU - Vemmos, K N

AU - Wolfe, C D A

AU - Woo, D

AU - Smith, E E

PY - 2010/10/12

Y1 - 2010/10/12

N2 - Objectives:: Antiplatelet therapy (APT) promotes bleeding; therefore, APT might worsen outcome in patients with intracerebral hemorrhage (ICH). We performed a systematic review and meta-analysis to address the hypothesis that pre-ICH APT use is associated with mortality and poor functional outcome following Ich. Methods:: The Medline and Embase databases were searched in February 2008 using relevant key words, limited to human studies in the English language. Cohort studies of consecutive patients with ICH reporting mortality or functional outcome according to pre-ICH APT use were identified. Of 2,873 studies screened, 10 were judged to meet inclusion criteria by consensus of 2 authors. Additionally, we solicited unpublished data from all authors of cohort studies with >100 patients published within the last 10 years, and received data from 15 more studies. Univariate and multivariable-adjusted odds ratios (ORs) for mortality and poor functional outcome were abstracted as available and pooled using a random effects model. Results:: We obtained mortality data from 25 cohorts (15 unpublished) and functional outcome data from 21 cohorts (14 unpublished). Pre-ICH APT users had increased mortality in both univariate (OR 1.41, 95% confidence interval [CI] 1.21 to 1.64) and multivariable-adjusted (OR 1.27, 95% CI 1.10 to 1.47) pooled analyses. By contrast, the pooled OR for poor functional outcome was no longer significant when using multivariable-adjusted estimates (univariate OR 1.29, 95% CI 1.09 to 1.53; multivariable-adjusted OR 1.10, 95% CI 0.93 to 1.29). Conclusions:: In cohort studies, APT use at the time of ICH compared to no APT use was independently associated with increased mortality but not with poor functional outcome.

AB - Objectives:: Antiplatelet therapy (APT) promotes bleeding; therefore, APT might worsen outcome in patients with intracerebral hemorrhage (ICH). We performed a systematic review and meta-analysis to address the hypothesis that pre-ICH APT use is associated with mortality and poor functional outcome following Ich. Methods:: The Medline and Embase databases were searched in February 2008 using relevant key words, limited to human studies in the English language. Cohort studies of consecutive patients with ICH reporting mortality or functional outcome according to pre-ICH APT use were identified. Of 2,873 studies screened, 10 were judged to meet inclusion criteria by consensus of 2 authors. Additionally, we solicited unpublished data from all authors of cohort studies with >100 patients published within the last 10 years, and received data from 15 more studies. Univariate and multivariable-adjusted odds ratios (ORs) for mortality and poor functional outcome were abstracted as available and pooled using a random effects model. Results:: We obtained mortality data from 25 cohorts (15 unpublished) and functional outcome data from 21 cohorts (14 unpublished). Pre-ICH APT users had increased mortality in both univariate (OR 1.41, 95% confidence interval [CI] 1.21 to 1.64) and multivariable-adjusted (OR 1.27, 95% CI 1.10 to 1.47) pooled analyses. By contrast, the pooled OR for poor functional outcome was no longer significant when using multivariable-adjusted estimates (univariate OR 1.29, 95% CI 1.09 to 1.53; multivariable-adjusted OR 1.10, 95% CI 0.93 to 1.29). Conclusions:: In cohort studies, APT use at the time of ICH compared to no APT use was independently associated with increased mortality but not with poor functional outcome.

U2 - http://dx.doi.org/10.1212/WNL.0b013e3181f735e5

DO - http://dx.doi.org/10.1212/WNL.0b013e3181f735e5

M3 - Journal article

SN - 0028-3878

VL - 75

SP - 1333

EP - 1342

JO - Neurology

JF - Neurology

IS - 15

ER -

Prior antiplatelet therapy and outcome following intracerebral hemorrhage: a systematic review

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