NEUROLOGY 2005;65:1000-1004
© 2005 American Academy of Neurology
Antiplatelet therapy contributes to acute deterioration of intracerebral hemorrhage
K. Toyoda, MD,
Y. Okada, MD,
K. Minematsu, MD,
M. Kamouchi, MD,
S. Fujimoto, MD,
S. Ibayashi, MD and
T. Inoue, MD
From the Departments of Cerebrovascular Disease (Drs. Toyoda, Okada, Kamouchi, and Fujimoto) and Neurosurgery (Dr. Inoue), Cerebrovascular Center and Clinical Research Institute, National Kyushu Medical Center, Fukuoka; Cerebrovascular Division, Department of Medicine, National Cardiovascular Center, Suita (Dr. Minematsu); and Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (Dr. Ibayashi).
Address correspondence and reprint requests to Dr. Kazunori Toyoda, Department of Cerebrovascular Disease and Clinical Research Institute, National Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka 810-8563, Japan; e-mail: toyoda{at}hsp.ncvc.go.jp
Objective: The purpose of this study was to examine the effect of antiplatelet therapy on the initial severity and the acute outcome of intracerebral hemorrhage (ICH).
Methods: The authors reviewed records of 251 consecutive patients hospitalized in their cerebrovascular center within 24 hours after onset of ICH.
Results: Fifty-seven patients (23%) had development of ICH during oral antiplatelet therapy. The major indication for antiplatelet therapy was the prevention of stroke recurrence (63%). As compared with patients without antiplatelet therapy, those who received antiplatelet therapy more frequently were aged 70 years or older (60% vs 35%; p < 0.001), had previous symptomatic ischemic stroke (54% vs 7%; p < 0.0001), had diabetes mellitus (26% vs 15%; p < 0.05), and had heart disease (32% vs 8%; p < 0.0001). Antiplatelet therapy was predictive of an increase in the hematoma volume by more than 40% on the second hospital day (hematoma enlargement, odds ratio [OR] 7.67, 95% CI 1.62 to 36.4) and the need for emergent surgical evacuation of the hematoma (OR 3.10, 95% CI 1.18 to 8.15). Antiplatelet therapy was an independent predictor for the occurrence of any of hematoma enlargement, emergent death, or evacuation surgery, which suggests that clinical deterioration occurs into the second hospital day (OR 7.45, 95% CI 2.46 to 22.5).
Conclusions: Antiplatelet therapy seems to contribute to the acute clinical deterioration of intracerebral hemorrhage.
Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the October 11 issue to find the title link for this article.
Supported in part by the Research Grant for Cardiovascular Diseases (15C-1) from the Japanese Ministry of Health, Labor and Welfare.
Disclosure: The authors report no conflicts of interest.
Received November 11, 2004. Accepted in final form June 14, 2005.
Related Article
-
October 11 Highlights
Neurology 2005 65: 976-977.
[Full Text]
[PDF]
This article has been cited by other articles:
|
|
|
|
 
C. J. Creutzfeldt, K. J. Becker, W.T. Longstreth Jr, D. L. Tirschwell, and J. R. Weinstein
Platelet Dysfunction in Intraparenchymal Hemorrhage
Stroke,
November 1, 2009;
40(11):
e645 - e645.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. M. Naidech, B. Jovanovic, S. Liebling, R. K. Garg, S. L. Bassin, B. R. Bendok, R. A. Bernstein, M. J. Alberts, and H. H. Batjer
Reduced Platelet Activity Is Associated With Early Clot Growth and Worse 3-Month Outcome After Intracerebral Hemorrhage
Stroke,
July 1, 2009;
40(7):
2398 - 2401.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. H. Sansing, S. R. Messe, B. L. Cucchiara, S. N. Cohen, P. D. Lyden, S. E. Kasner, and For the CHANT Investigators
Prior antiplatelet use does not affect hemorrhage growth or outcome after ICH
Neurology,
April 21, 2009;
72(16):
1397 - 1402.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Toyoda, M. Yasaka, K. Iwade, K. Nagata, Y. Koretsune, T. Sakamoto, S. Uchiyama, J. Gotoh, T. Nagao, M. Yamamoto, et al.
Dual Antithrombotic Therapy Increases Severe Bleeding Events in Patients With Stroke and Cardiovascular Disease: A Prospective, Multicenter, Observational Study
Stroke,
June 1, 2008;
39(6):
1740 - 1745.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. E. Mayo, L. Nadeau, S. S. Daskalopoulou, and R. Cote
The evolution of stroke in Quebec: A 15-year perspective
Neurology,
April 3, 2007;
68(14):
1122 - 1127.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Wada, R. I. Aviv, A. J. Fox, D. J. Sahlas, D. J. Gladstone, G. Tomlinson, and S. P. Symons
CT Angiography "Spot Sign" Predicts Hematoma Expansion in Acute Intracerebral Hemorrhage
Stroke,
April 1, 2007;
38(4):
1257 - 1262.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. P. Broderick, M. N. Diringer, M. D. Hill, N. C. Brun, S. A. Mayer, T. Steiner, B. E. Skolnick, S. M. Davis, and for the Recombinant Activated Factor VII Intracere
Determinants of Intracerebral Hemorrhage Growth: An Exploratory Analysis
Stroke,
March 1, 2007;
38(3):
1072 - 1075.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Ferguson and R. Body
Use of aspirin in acute stroke.
Emerg. Med. J.,
October 1, 2006;
23(10):
804 - 805.
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Foerch, M. Sitzer, H. Steinmetz, T. Neumann-Haefelin, and for the Arbeitsgruppe Schlaganfall Hessen
Pretreatment With Antiplatelet Agents Is Not Independently Associated With Unfavorable Outcome in Intracerebral Hemorrhage
Stroke,
August 1, 2006;
37(8):
2165 - 2167.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. S. Wong and K. Toyoda
Antiplatelet therapy contributes to acute deterioration of intracerebral hemorrhage
Neurology,
May 23, 2006;
66(10):
1610 - 1611.
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Juvela and C. S. Kase
Advances in Intracerebral Hemorrhage Management
Stroke,
February 1, 2006;
37(2):
301 - 304.
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Tuhrim
Aspirin-Use Before ICH: A Potentially Treatable Iatrogenic Coagulopathy?
Stroke,
January 1, 2006;
37(1):
4 - 5.
[Full Text]
[PDF]
|
|
|
Correspondence:
Read all Correspondence
- Antiplatelet therapy contributes to acute deterioration of intracerebral hemorrhage
- Ka Sing Wong
- Neurology Online, 1 Feb 2006
[Full text]
- Reply from the Author
- Kazunori Toyoda
- Neurology Online, 1 Feb 2006
[Full text]
|
