| Title: |
Association of oral anticoagulants with risk of brain haemorrhage expansion compared to no-anticoagulation |
| Authors: |
Veltkamp, Roland; Haas, Kirsten; Rücker, Viktoria; Malzahn, Uwe; Heeger, Adrian; Kinzler, David; Müller, Patrick; Rappard, Pascal; Rizos, Timolaos; Schiefer, Johannes; Opherk, Christian; Pfeilschifter, Waltraud; Althaus, Katharina; Schellinger, Peter; Gaida, Bernadette; Gabriel, Maria Magdalena; Royl, Georg; Nabavi, Darius G.; Haeusler, Karl Georg; Nolte, Christian H.; Wolf, Marc E.; Poli, Sven; Sieber, Marilen; Mosimann, Pascal; Heuschmann, Peter U.; Purrucker, Jan C.; Horstmann, Solveig; Krauß, Alexandra; Renninger, Caroline; Ringleb, Peter; Reich, Arno; Kohler, Eve; Boss, Erendira; Schaefer, Jan Hendrik; Pflug, Marc; von Sarnowski, Bettina; Große, Gerrit Maximilian; Ernst, Johanna; Weißenborn, Karin; Schupper, Ramona; Worthmann, Hans; Riebau, Susanne; Crome, Olaf; Dimitrijeski, Boris; Offermann, Jens; Rangus, Ida; Schmid, Elisabeth; Poli, Khouloud; Tünnerhoff, Johannes; Michalski, Dominik |
| Contributors: |
Bayer Vital; Bristol-Myers Squibb and Pfizer Alliance; Boehringer Ingelheim; Daiichi Sankyo Europe; Medizinische Fakultät Heidelberg der Universität Heidelberg |
| Source: |
Neurological Research and Practice ; volume 7, issue 1 ; ISSN 2524-3489 |
| Publisher Information: |
Springer Science and Business Media LLC |
| Publication Year: |
2025 |
| Description: |
Background The impact of direct oral anticoagulants (DOAC) on haematoma size after intracerebral haemorrhage (ICH) compared to no-anticoagulation is controversial and prospective data are lacking. Methods The investigator-initiated, multicentre, prospective RASUNOA-prime study enrolled patients with non-traumatic ICH and atrial fibrillation while on a DOAC, vitamin K antagonist (VKA) or no anticoagulation (non-OAC). Neuroimaging was reviewed centrally blinded to group allocation. Primary endpoint was haematoma expansion (≥ 6.5 ml or ≥ 33%, any new intraventricular blood or an increase in modified Graeb score by ≥ 2 points) between baseline and follow-up scan within 72 h after symptom onset. Results Of 1,440 patients screened, 951 patients with ICH symptom onset less than 24 h before admission were enrolled. Baseline scans were performed at a median of 2 h (IQR 1–6) after symptom onset. Neurological deficit and median baseline haematoma volumes (11 ml; IQR 4–39) did not differ among 577 DOAC, 251 VKA and 123 non-OAC patients. Haematoma expansion was observed in DOAC patients in 142/356 (39.9, 95%-CI 34.8–45.0%), VKA in 47/155 (30.3, 95-CI 23.1%–37.6%), versus non-OAC in 22/74 (29.7, 19.3–40.1%). Unspecific reversal agents in DOAC-ICH (212/356, 59.6%) did not affect the haematoma expansion rate compared to no-antagonization. Conclusion Baseline haematoma volume and risk of haematoma expansion did not differ statistically significantly in patients with and without DOAC. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1186/s42466-024-00358-9 |
| DOI: |
10.1186/s42466-024-00358-9.pdf |
| DOI: |
10.1186/s42466-024-00358-9/fulltext.html |
| Availability: |
https://doi.org/10.1186/s42466-024-00358-9; https://link.springer.com/content/pdf/10.1186/s42466-024-00358-9.pdf; https://link.springer.com/article/10.1186/s42466-024-00358-9/fulltext.html |
| Rights: |
https://creativecommons.org/licenses/by/4.0 ; https://creativecommons.org/licenses/by/4.0 |
| Accession Number: |
edsbas.493EA5A3 |
| Database: |
BASE |