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

Simple item page
dc.contributor.authorSong, Lili
dc.contributor.authorSandset, Else Charlotte
dc.contributor.authorArima, Hisatomi
dc.contributor.authorHeeley, Emma
dc.contributor.authorDelcourt, Candice
dc.contributor.authorChen, Guofeng
dc.contributor.authorYang, Jie
dc.contributor.authorWu, Guojun
dc.contributor.authorWang, Xia
dc.contributor.authorLavados, Pablo
dc.contributor.authorHuang, Yining
dc.contributor.authorStampf, Christian
dc.contributor.authorWang, Jiguang
dc.contributor.authorRobinson, Thompson
dc.contributor.authorChalmers, John
dc.contributor.authorLindley, Richard
dc.contributor.authorAnderson, Craig
dc.date.accessioned2017-08-17T11:59:07Z
dc.date.available2017-08-17T11:59:07Z
dc.date.issued2016
dc.description.abstractOBJECTIVE: 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.
dc.format.extent6
dc.identifier.citationJ Neurol Neurosurg Psychiatry. 2016 Dec;87(12):1330-1335
dc.identifier.urihttp://hdl.handle.net/11447/1584
dc.identifier.urihttp://dx.doi.org/10.1136/jnnp-2016-313246
dc.language.isoen_US
dc.publisherBMJ Publishing Group
dc.subjectAntihypertensive Agents/therapeutic use
dc.subjectCerebral Hemorrhage/chemically induced
dc.subjectEarly Medical Intervention
dc.subjectFibrinolytic Agents/adverse effects
dc.subjectHypertension/drug therapy
dc.subjectPreoperative Care
dc.titleEarly blood pressure lowering in patients with intracerebral haemorrhage and prior use of antithrombotic agents: pooled analysis of the INTERACT studies
dc.typeArtículo

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Early blood pressure lowering in patients with intracerebral haemorrhage and prior use of antithrombotic agents.pdf
Size:
183.93 KB
Format:
Adobe Portable Document Format
Description:
Resumen
Download

Collections

Artículos Medicina y Ciencias de la Salud

Implementado por OpenGeek Services