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Early blood pressure lowering in patients with intracerebral haemorrhage and prior use of antithrombotic agents: pooled analysis of the INTERACT studies

Show simple item record Song, Lili Sandset, Else Charlotte Arima, Hisatomi Heeley, Emma Delcourt, Candice Chen, Guofeng Yang, Jie Wu, Guojun Wang, Xia Lavados, Pablo Huang, Yining Stampf, Christian Wang, Jiguang Robinson, Thompson Chalmers, John Lindley, Richard Anderson, Craig 2017-08-17T11:59:07Z 2017-08-17T11:59:07Z 2016
dc.identifier.citation J Neurol Neurosurg Psychiatry. 2016 Dec;87(12):1330-1335 es_CL
dc.identifier.uri es_CL
dc.description.abstract OBJECTIVE: Antithrombotic agents increase risks of intracerebral haemorrhage (ICH) and associated adverse outcomes. We determined differential effects of early blood pressure (BP) lowering in patients with/without antithrombotic-associated ICH in the Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trials (INTERACT1 and 2). DESIGN: Post hoc pooled analyses of the INTERACT studies-international, multicentre, prospective, open, blinded end point trials of patients with ICH (<6 h) and elevated systolic BP (SBP 150-180 mm Hg) randomly assigned to intensive (target SBP <140 mm Hg) or guideline-based (SBP <180 mm Hg) BP management. Associations of antithrombotic use and (1) death or dependency (modified Rankin scale scores 3-6) were analysed using logistic regression, and (2) of increased haematoma+intraventricular haemorrhage volume (IVH) with/without intraventricular haemorrhage (IVH) over 24 h were estimated in analyses of covariance. RESULTS: In all, 3184 patients were included in these analyses. Antithrombotic-associated ICH (364 patients, 11%) was not associated with a significantly increased risk of death or dependency (OR 1.38, 95% CI 0.93 to 2.04). There was no heterogeneity in the BP-lowering treatment effect on death or dependency. Among 1309 patients who underwent follow-up CT after 24 h, absolute increase in haematoma±IVH volume was larger (5.2/5.0 mL) in those with compared to those without prior antithrombotics (2.2/0.9 mL; p=0.022/0.031). Intensive BP lowering reduced haematoma±IVH growth by 4.7/7.1 mL in patients on antithrombotics versus 1.3/1.4 mL in those without, although these differences did not reach statistical significance (p homogeneity=0.104/0.059). CONCLUSIONS: In patients with ICH, prior antithrombotic therapy is associated with greater haematoma growth, which may be reduced by early intensive BP-lowering treatment. es_CL
dc.format.extent 6 es_CL
dc.language.iso en_US es_CL
dc.publisher BMJ Publishing Group es_CL
dc.subject Antihypertensive Agents/therapeutic use es_CL
dc.subject Cerebral Hemorrhage/chemically induced es_CL
dc.subject Early Medical Intervention es_CL
dc.subject Fibrinolytic Agents/adverse effects es_CL
dc.subject Hypertension/drug therapy es_CL
dc.subject Preoperative Care es_CL
dc.title Early blood pressure lowering in patients with intracerebral haemorrhage and prior use of antithrombotic agents: pooled analysis of the INTERACT studies es_CL
dc.type Artículo es_CL

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