Reversal strategies for vitamin K antagonists in acute intracerebral hemorrhage

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...

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Bibliographic Details
Published in:Annals of neurology 2015-07, Vol.78 (1), p.54-62
Main Authors: Parry-Jones, Adrian R., Di Napoli, Mario, Goldstein, Joshua N., Schreuder, Floris H. B. M., Tetri, Sami, Tatlisumak, Turgut, Yan, Bernard, van Nieuwenhuizen, Koen M., Dequatre-Ponchelle, Nelly, Lee-Archer, Matthew, Horstmann, Solveig, Wilson, Duncan, Pomero, Fulvio, Masotti, Luca, Lerpiniere, Christine, Godoy, Daniel Agustin, Cohen, Abigail S., Houben, Rik, Al-Shahi Salman, Rustam, Pennati, Paolo, Fenoglio, Luigi, Werring, David, Veltkamp, Roland, Wood, Edith, Dewey, Helen M., Cordonnier, Charlotte, Klijn, Catharina J. M., Meligeni, Fabrizio, Davis, Stephen M., Huhtakangas, Juha, Staals, Julie, Rosand, Jonathan, Meretoja, Atte
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Anticoagulants - adverse effects
Antifibrinolytic Agents - therapeutic use
Blood Coagulation Factors - therapeutic use
Cerebral Hemorrhage - chemically induced
Cerebral Hemorrhage - mortality
Cerebral Hemorrhage - therapy
Confidence intervals
Fatalities
Female
Humans
Male
Plasma
Proportional Hazards Models
Registries
Retrospective Studies
Stroke
Treatment Outcome
Vitamin K - antagonists & inhibitors
Vitamin K - therapeutic use
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Summary: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 
ISSN:0364-5134
1531-8249
DOI:10.1002/ana.24416