Prior antiplatelet therapy and outcome following intracerebral hemorrhage A systematic review

被引：157

作者：

Thompson, B. B. ^{[2
,3
]}

Bejot, Y.

Caso, V. ^{[4
]}

Castillo, J. ^{[5
]}

Christensen, H. ^{[6
]}

Flaherty, M. L. ^{[7
]}

Foerch, C. ^{[8
]}

Ghandehari, K. ^{[9
]}

Giroud, M. ^{[10
]}

Greenberg, S. M. ^{[11
]}

Hallevi, H. ^{[12
]}

Hemphill, J. C., III ^{[13
]}

Heuschmann, P. ^{[15
]}

Juvela, S. ^{[16
]}

Kimura, K. ^{[17
]}

Myint, P. K. ^{[18
,19
]}

Nagakane, Y. ^{[20
]}

Naritomi, H. ^{[20
]}

Passero, S. ^{[21
]}

Rodriguez-Yanez, M. R. ^{[5
]}

Roquer, J. ^{[22
]}

Rosand, J. ^{[11
]}

Rost, N. S. ^{[11
]}

Saloheimo, P. ^{[23
,24
]}

Salomaa, V. ^{[25
]}

Sivenius, J. ^{[26
]}

Sorimachi, T. ^{[27
]}

Togha, M. ^{[28
]}

Toyoda, K. ^{[20
]}

Turaj, W. ^{[29
]}

Vemmos, K. N. ^{[30
]}

Wolfe, C. D. A. ^{[14
]}

Woo, D. ^{[7
]}

Smith, E. E. ^{[1
]}

机构：

[1] Univ Calgary, Foothills Med Ctr, Dept Clin Neurosci, Calgary, AB T2N 2T9, Canada

[2] Brown Univ, Dept Neurol, Providence, RI 02912 USA

[3] Brown Univ, Dept Neurosurg, Providence, RI 02912 USA

[4] Osped Santa Maria Misericordia, Stroke Unit, Perugia, Italy

[5] Univ Santiago, Hosp Clin, Dept Neurol, Santiago De Compostela, Spain

[6] Univ Copenhagen, Dept Neurol, Bispebjerg Hosp, DK-1168 Copenhagen, Denmark

[7] Univ Cincinnati, Acad Hlth Ctr, Dept Neurol, Cincinnati, OH 45221 USA

[8] Goethe Univ Frankfurt, Dept Neurol, Frankfurt, Germany

[9] Mashhad Univ Med Sci, Ghaem Hosp, Dept Neurol, Mashhad, Iran

[10] INSERM, Stroke Registry Dijon, F-75654 Paris 13, France

[11] Massachusetts Gen Hosp, Dept Neurol, Boston, MA 02114 USA

[12] Tel Aviv Univ, Tel Aviv Sourasky Med Ctr, Dept Neurol, IL-69978 Tel Aviv, Israel

[13] Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA

[14] Kings Coll London, Div Hlth & Social Care Res, R&D Guys & St Thomas Fdn Trust, London, England

[15] Charite Univ Med Berlin, Ctr Stroke Res Berlin, Berlin, Germany

[16] Turku Univ, Cent Hosp, Dept Neurosurg, Turku, Finland

[17] Kawasaki Med Sch, Dept Stroke Med, Kurashiki, Okayama, Japan

[18] Univ E Anglia, Sch Med Hlth Policy & Practice, Norwich NR4 7TJ, Norfolk, England

[19] Norfolk & Norwich Univ Hosp, Dept Med Elderly, Norwich NR4 7TJ, Norfolk, England

[20] Natl Cerebral & Cardiovasc Ctr, Dept Cerebrovasc Med, Osaka, Japan

[21] Univ Siena, Neurol Unit, Dept Neurosci, I-53100 Siena, Italy

[22] Hosp del Mar, Unitat Ietus, Barcelona, Spain

[23] Univ Oulu, Dept Neurol, Oulu, Finland

[24] Kellokoski Hosp, Dept Neuropsychiat & Psychogeriatr, Tuusula, Finland

[25] KTL Natl Publ Hlth Inst, Dept Epidemiol & Hlth Promot, Helsinki, Finland

[26] Kuopio Univ Hosp, Brain Res & Rehabil Ctr Neuron, SF-70210 Kuopio, Finland

[27] Niigata Univ, Brain Res Inst, Dept Neurosurg, Niigata 95021, Japan

[28] Univ Tehran Med Sci, Sina Hosp, Dept Neurol, Tehran, Iran

[29] Jagiellonian Univ, Coll Med, Dept Neurol, Krakow, Poland

[30] Univ Athens, Sch Med, Alexandra Hosp, Dept Clin Therapeut,Acute Stroke Unit, GR-11527 Athens, Greece

来源：

NEUROLOGY | 2010年 / 75卷 / 15期

基金：

芬兰科学院;

关键词：

CASE-FATALITY RATES; INDEPENDENT PREDICTOR; STROKE REGISTRY; ISCHEMIC-STROKE; EARLY DEATH; MORTALITY; ASPIRIN; RISK; ANTICOAGULATION; DETERIORATION;

D O I：

10.1212/WNL.0b013e3181f735e5

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

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. Neurology (R) 2010;75:1333-1342

引用

页码：1333 / 1342

页数：10

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