Heparin therapy, deep-vein thrombosis and pulmonary embolism after intracerebral hemorrhage

Dickmann, Ulrich; Voth, E.; Schicha, H.; Henze, Thomas; Prange, Hilmar; Emrich, D.

doi:10.1007/bf01727666

Cited by 76 publications

(71 citation statements)

References 7 publications

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“…Of the nine trials (2043 patients) of antiplatelet drugs (1997 patients) or anticoagulants (645 patients) given after acute intracranial haemorrhage that were identified, including the IST and CAST 42,[313][314][315][316][317][318][319] ( Tables 35 and 36), eight were randomised trials 41,42,[314][315][316][318][319][320] and one was a double-blind comparative study that gave no information on whether treatment allocation was randomised or not 317 . However, on balance, a decision was made to include it.…”

Section: Details Of the Included Trialsmentioning

confidence: 99%

“…However, on balance, a decision was made to include it. An additional publication that added an extra group of patients to a trial already included in the review 316 was excluded. 321 The intracranial haemorrhage was due to SAH in six trials (1224 patients), [313][314][315],317-319 a mixture of acute intraparenchymal cerebral haemorrhage and haemorrhagic transformation of cerebral infarction in two trials (773 patients) 41,42 and proven PICH in one trial (46 patients).…”

Section: Details Of the Included Trialsmentioning

confidence: 99%

“…321 The intracranial haemorrhage was due to SAH in six trials (1224 patients), [313][314][315],317-319 a mixture of acute intraparenchymal cerebral haemorrhage and haemorrhagic transformation of cerebral infarction in two trials (773 patients) 41,42 and proven PICH in one trial (46 patients). 316 In two of the SAH trials, the antiplatelet trial drugs were given after the aneurysms had been surgically clipped to prevent rebleeding; 318,319 in one the antiplatelet trial drugs were definitely started before any clipping of the aneurysm; 315 and in three trials there was no indication as to whether the aneurysm had been securely treated before starting the antiplatelet trial drugs. 313,314,317 The duration of the scheduled treatment period ranged from 8 days 318 to 3 months, 315 and three studies did not clearly specify the duration of treatment.…”

Section: Details Of the Included Trialsmentioning

confidence: 99%

“…313,314,317 The duration of the scheduled treatment period ranged from 8 days 318 to 3 months, 315 and three studies did not clearly specify the duration of treatment. 313,314,316 The length of follow-up ranged from 1 month 42,318 to 6 months, 41,314 and one study did not specify the length of follow-up. 316 The primary outcome was (Tables 35 and 36): G death in four studies: within the scheduled treatment period in two studies, 41,42 within the follow-up period of 6 months in one study 314 and the period was not specified in one study 316 G 'neurological disability' measured by Glasgow Outcome Score in two studies, 315,318 the Japanese Coma Scale in one study 317 and unspecified in two studies 313,314 G functional outcome (i.e.…”

Section: Details Of the Included Trialsmentioning

confidence: 99%

“…313,314,316 The length of follow-up ranged from 1 month 42,318 to 6 months, 41,314 and one study did not specify the length of follow-up. 316 The primary outcome was (Tables 35 and 36): G death in four studies: within the scheduled treatment period in two studies, 41,42 within the follow-up period of 6 months in one study 314 and the period was not specified in one study 316 G 'neurological disability' measured by Glasgow Outcome Score in two studies, 315,318 the Japanese Coma Scale in one study 317 and unspecified in two studies 313,314 G functional outcome (i.e. Rankin or simplified equivalent) in three studies 41,42,319 and pulmonary embolus and deep vein thrombosis in one study.…”

Section: Details Of the Included Trialsmentioning

confidence: 99%

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What is the best imaging strategy for acute stroke?

Wardlaw

Keir²,

Seymour³

et al. 2004

Health Technol Assess

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Section: Details Of the Included Trialsmentioning

confidence: 99%

Section: Details Of the Included Trialsmentioning

confidence: 99%

Section: Details Of the Included Trialsmentioning

confidence: 99%

Section: Details Of the Included Trialsmentioning

confidence: 99%

Section: Details Of the Included Trialsmentioning

confidence: 99%

See 3 more Smart Citations

What is the best imaging strategy for acute stroke?

Wardlaw

Keir²,

Seymour³

et al. 2004

Health Technol Assess

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Antithrombotic treatment after stroke due to intracerebral haemorrhage

Perry

Berge

Bowditch

et al. 2017

Cochrane Database of Systematic Reviews

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Antithrombotic treatment after stroke due to intracerebral haemorrhage

Cochrane

Chen

Stephen

et al. 2023

Cochrane Database of Systematic Reviews

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Background This is an update of the Cochrane Review last published in 2017. Survivors of stroke due to intracerebral haemorrhage (ICH) are at risk of major adverse cardiovascular events (MACE). Antithrombotic (antiplatelet or anticoagulant) treatments may lower the risk of ischaemic MACE after ICH, but they may increase the risk of bleeding. Objectives To determine the overall effectiveness and safety of antithrombotic drugs on MACE and its components for people with ICH. Search methods We searched the Cochrane Stroke Group Trials Register (5 October 2021). We also searched the Cochrane Central Register of Controlled Trials (CENTRAL: the Cochrane Library 2021, Issue 10), MEDLINE Ovid (from 1948 to October 2021) and Embase Ovid (from 1980 to October 2021). The online registries of clinical trials searched were the US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov (clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (5 October 2021). We screened the reference lists of included randomised controlled trials (RCTs) for additional, potentially relevant RCTs. Selection criteria We selected RCTs in which participants with ICH of any age were allocated to a class of antithrombotic treatment as intervention or comparator. Data collection and analysis In accordance with standard methodological procedures recommended by Cochrane, two review authors assessed each selected RCT for its risk of bias and extracted data independently. The primary outcome was a composite of MACE, and secondary outcomes included death, individual components of the MACE composite, ICH growth, functional status and cognitive status. We estimated effects using the frequency of outcomes that occurred during the entire duration of follow‐up and calculated a risk ratio (RR) for each RCT. We grouped RCTs separately for analysis according to 1) the class(es) of antithrombotic treatment used for the intervention and comparator, and 2) the duration of antithrombotic treatment use (short term versus long term). We pooled the intention‐to‐treat populations of RCTs using a fixed‐effect model for meta‐analysis, but used a random‐effects model if RCTs differed substantially in their design or there was considerable heterogeneity (I 2 ≥ 75%) in their results. We applied GRADE to assess the certainty of the evidence. Main results We identified seven new completed RCTs for this update, resulting in the inclusion of a total of nine RCTs based in secondary care, comprising 1491 participants (average age ranged from 61 to 79 years and the proportion of men ranged from 44% to 67%). The proportion of included RCTs at low risk of bias, by category was: random sequence generation (67%), allocation concealment (67%), performance (22%), detection (78%), attrition (89%), and reporting...

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Heparin therapy, deep-vein thrombosis and pulmonary embolism after intracerebral hemorrhage

Cited by 76 publications

References 7 publications

What is the best imaging strategy for acute stroke?

What is the best imaging strategy for acute stroke?

Antithrombotic treatment after stroke due to intracerebral haemorrhage

Antithrombotic treatment after stroke due to intracerebral haemorrhage

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