PT  - JOURNAL ARTICLE
AU  - Siepen, Bernhard M
AU  - Forfang, Elisabeth
AU  - Branca, Mattia
AU  - Drop, Boudewijn
AU  - Mueller, Madlaine
AU  - Goeldlin, Martina B
AU  - Katan, Mira
AU  - Michel, Patrik
AU  - Cereda, Carlo
AU  - Medlin, Friedrich
AU  - Peters, Nils
AU  - Renaud, Susanne
AU  - Niederhauser, Julien
AU  - Carrera, Emmanuel
AU  - Kahles, Timo
AU  - Kägi, Georg
AU  - Bolognese, Manuel
AU  - Salmen, Stephan
AU  - Mono, Marie-Luise
AU  - Polymeris, Alexandros A
AU  - Wegener, Susanne
AU  - Z'Graggen, Werner
AU  - Kaesmacher, Johannes
AU  - Schaerer, Michael
AU  - Rodic, Biljana
AU  - Kristoffersen, Espen Saxhaug
AU  - Larsen, Kristin T
AU  - Wyller, Torgeir Bruun
AU  - Volbers, Bastian
AU  - Meinel, Thomas R
AU  - Arnold, Marcel
AU  - Engelter, Stefan T
AU  - Bonati, Leo H
AU  - Fischer, Urs
AU  - Rønning, Ole Morten
AU  - Seiffge, David J
TI  - Intracerebral haemorrhage in patients taking different types of oral anticoagulants: a pooled individual patient data analysis from two national stroke registries
AID  - 10.1136/svn-2023-002813
DP  - 2024 Dec 01
TA  - Stroke and Vascular Neurology
PG  - 640--651
VI  - 9
IP  - 6
4099  - http://svn.bmj.com/content/9/6/640.short
4100  - http://svn.bmj.com/content/9/6/640.full
SO  - Stroke Vasc Neurol2024 Dec 01; 9
AB  - Background We investigated outcomes in patients with intracerebral haemorrhage (ICH) according to prior anticoagulation treatment with Vitamin K antagonists (VKAs), direct oral anticoagulants (DOACs) or no anticoagulation.Methods This is an individual patient data study combining two prospective national stroke registries from Switzerland and Norway (2013–2019). We included all consecutive patients with ICH from both registries. The main outcomes were favourable functional outcome (modified Rankin Scale 0–2) and mortality at 3 months.Results Among 11 349 patients with ICH (mean age 73.6 years; 47.6% women), 1491 (13.1%) were taking VKAs and 1205 (10.6%) DOACs (95.2% factor Xa inhibitors). The median percentage of patients on prior anticoagulation was 23.7 (IQR 22.6–25.1) with VKAs decreasing (from 18.3% to 7.6%) and DOACs increasing (from 3.0% to 18.0%) over time. Prior VKA therapy (n=209 (22.3%); adjusted ORs (aOR), 0.64; 95% CI, 0.49 to 0.84) and prior DOAC therapy (n=184 (25.7%); aOR, 0.64; 95% CI, 0.47 to 0.87) were independently associated with lower odds of favourable outcome compared with patients without anticoagulation (n=2037 (38.8%)). Prior VKA therapy (n=720 (49.4%); aOR, 1.71; 95% CI, 1.41 to 2.08) and prior DOAC therapy (n=460 (39.7%); aOR, 1.28; 95% CI, 1.02 to 1.60) were independently associated with higher odds of mortality compared with patients without anticoagulation (n=2512 (30.2%)).Conclusions The spectrum of anticoagulation-associated ICH changed over time. Compared with patients without prior anticoagulation, prior VKA treatment and prior DOAC treatment were independently associated with lower odds of favourable outcome and higher odds of mortality at 3 months. Specific reversal agents unavailable during the study period might improve outcomes of DOAC-associated ICH in the future.Data are available upon reasonable request. Anonymized data may be obtained upon reasonable request from any qualified investigator and after clearance by the local ethics committee and the steering committees from the Swiss and Norwegian Stroke Registries.