TITLE

Effect of On-Admission Antiplatelet Treatment on Patients with Cerebral Hemorrhage

AUTHOR(S)
Caso, Valeria; Paciaroni, Maurizio; Venti, Michele; Alberti, Andrea; Palmerini, Francesco; Milia, Paolo; Billeci, Antonia M. R.; Silvestrelli, Giorgio; Biagini, Sergio; Agnelli, Giancarlo
PUB. DATE
August 2007
SOURCE
Cerebrovascular Diseases;2007, Vol. 24 Issue 2/3, p215
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Antiplatelet treatment remains the first choice for primary and secondary prevention of vascular diseases; even so, expected benefits may be offset by risk of bleeding, particularly cerebral hemorrhage. The aim of this study was to assess the influence of antiplatelet treatment on clinical outcome at hospital discharge. Materials and Methods: Consecutive patients with first-ever stroke due to a primary intraparenchymal hemorrhage were prospectively identified over a 4-year period (2000–2003). Data on hemorrhage location, vascular risk factors, and antiplatelet and anticoagulant treatment were collected. At discharge, outcome was measured using the modified Rankin Scale (disabling stroke ≥3). Patients treated with anticoagulant therapy were excluded from the study. Results: Of 457 consecutive patients with cerebral hemorrhage, 94 (20.5%) had been taking antiplatelet agents. The treated patients (mean age for antiplatelet group 78.9 ± 9.0 years) were older than the nontreated patients (73.8 ± 9.4, p = 0.02). In-hospital mortality was 23.4 and 23.1% (p = n.s.) for patients who had been taking antiplatelet agents or no treatment. Poor outcome at discharge was found in 52.1 and 59.7% (p = n.s.), respectively. Univariate analysis showed that age and coma at admission were predictors of disability at discharge, but antiplatelet treatment was not. Additionally, age and coma were shown to be determinants of disability at discharge after multivariate analysis: OR 1.03 per year (95% CI: 1.018–1.049), p < 0.001 and OR 1.68 (95% CI: 1.138–2.503), p = 0.009, respectively. Conclusions: Hemorrhagic stroke continues to be responsible for a high percentage of disability and death. Furthermore, it was seen here that functional outcome was independent of previous antiplatelet treatment. Copyright © 2007 S. Karger AG, Basel
ACCESSION #
26548417

 

Related Articles

  • Validation of the Intracerebral Haemorrhage Score for prognosis of stroke patients in clinical practice. Sharma, J. C.; Mehndiratta, M. M. // Annals of Indian Academy of Neurology;Nov2008 Supplement, Vol. 11, pS166 

    Background and Aims: The Intracerebral Haemorrhage Score (ICH) is a measure of prognosis of patients admitted with a haemorrhagic stroke. We aimed to evaluate this in our patients. Methods: Thirty consecutive patients were studied for ICH score, age 41-93, mean 73±13 years. Outcome was...

  • Gender Differences in Mortality after Hospital Admission for Stroke. Vaartjes, I.; Reitsma, J. B.; Berger-van Sijl, M.; Bots, M. L. // Cerebrovascular Diseases;Dec2009, Vol. 28 Issue 6, p564 

    Background: Differences between men and women in stroke symptoms, management and disability have been reported to be unfavorable for women. Yet, studies into differences between men and women in survival after a stroke yielded inconsistent results. We investigated whether gender was associated...

  • Review: Anticoagulants increase intracerebral bleeding and do not reduce death or disability in acute cardioembolic stroke: COMMENTARY. Johnston, S. Claiborne // ACP Journal Club;Jul/Aug2007, Vol. 147 Issue 1, p17 

    The author reflects on a study, conducted by M. Paciaroni and colleagues, which focuses on the effectiveness and safety of anticoagulants as initial treatment in patients with acute cardioembolic stroke. He views that during prophylaxis lower doses of anticoagulants seem to give better results...

  • Cost analysis of early supported hospital discharge for stroke. McNamee, Paul; Christensen, Jakob; Soutter, Jennifer; Rodgers, Helen; Craig, Neil; Pearson, Pauline; Bond, John // Age & Ageing;May98, Vol. 27 Issue 3, p345 

    Provides information on a study measuring the net costs to the health and personal social services of an early supported discharge policy for stroke. Methodology used to conduct the study; Characteristics of the patients used in the study; Percentage of reduced hospital length stay; Findings of...

  • Hospital Discharge Rates for Cerebrovascular Disease--United States, 1970-1986.  // JAMA: Journal of the American Medical Association;5/5/89, Vol. 261 Issue 17, p2486 

    Discusses the contents of the report 'Hospital Discharge Rates for Cerebrovascular Disease--United States, 1970-1986.' Sources of data; General category of cerebrovascular disease; Observed changes in hospital discharge rates.

  • Older patients with acute stroke in Denmark: quality of care and short-term mortality. A nationwide follow-up study. Palnum, Kaare Dyre; Petersen, Palle; Sørensen, Henrik Toft; Ingeman, Anette; Mainz, Jan; Bartels, Paul; Johnsen, Sø Paaske // Age & Ageing;Jan2008, Vol. 37 Issue 1, p90 

    Background and purpose age may predict level of care and subsequent outcome among patients with stroke. We examined fulfilment of quality-of-care criteria according to age and the possible impact of any age-related differences on short-term mortality in a population-based nationwide follow-up...

  • Genotype-guided warfarin dosing now a reality. Cooper-DeHoff, Rhonda M.; Pacanowski, Michael A. // Cardiology Today;Feb2008, Vol. 11 Issue 2, p18 

    The article provides information on the use of the drug warfarin. It states that the drug is the most commonly prescribed oral anticoagulant and is effective for treating thromboembolism and stroke. It is noted that optimal warfarin dosage is difficult because of its narrow therapeutic index and...

  • Initiation of Oral Anticoagulation after Acute Ischaemic Stroke or Transient Ischaemic Attack: Timing and Complications of Overlapping Heparin or Conventional Treatment. Audebert, Heinrich J.; Schenk, Berit; Tietz, Viola; Schenkel, Johannes; Heuschmann, Peter U. // Cerebrovascular Diseases;Aug2008, Vol. 26 Issue 2, p171 

    Background: Oral anticoagulation is highly effective for secondary prevention of cardioembolic strokes in patients with atrial fibrillation (AF). There are no studies investigating timing and complications of different strategies for initiation of oral anticoagulation after acute stroke or...

  • Ximelagatran was non-inferior to warfarin in preventing stroke and systemic embolism in atrial fibrillation. Van Walraven, Carl // Evidence Based Medicine;Mar/Apr2004, Vol. 9 Issue 2, p43 

    This article presents information about a study which reveals that in patients with atrial fibrillation (AF) at risk of ischaemic stroke, ximelagatran was non-inferior to warfarin in preventing stroke and systemic embolism. From a practical standpoint, ximelagatran is an easier drug to use than...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics