Imperial College London
Alternate

ProfessorRolandVeltkamp

Faculty of Medicine, Department of Brain Sciences

Professor of Neurology and Chair of Stroke Medicine
 
 
 
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Contact

 

r.veltkamp

 
 
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Location

 

3 East6East WingCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Korompoki:2017:10.1212/WNL.0000000000004235,
author = {Korompoki, E and Filippidis, FT and Nielsen, PB and Del, Giudice A and Lip, GYH and Kuramatsu, JB and Huttner, HB and Fang, J and Schulman, S and Marti-Fabregas, J and Gathier, CS and Viswanathan, A and Biffi, A and Poli, D and Weimar, C and Malzahn, U and Heuschmann, P and Veltkamp, R},
doi = {10.1212/WNL.0000000000004235},
journal = {NEUROLOGY},
pages = {687--696},
title = {Long-term antithrombotic treatment in intracranial hemorrhage survivors with atrial fibrillation},
url = {http://dx.doi.org/10.1212/WNL.0000000000004235},
volume = {89},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objective: To perform a systematic review and meta-analysis of studies reporting recurrent intracranial hemorrhage (ICH) and ischemic stroke (IS) in ICH survivors with atrial fibrillation (AF) during long-term follow-up.Methods: A comprehensive literature search including MEDLINE, EMBASE, Cochrane library, clinical trials registry was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We considered studies capturing outcome events (ICH recurrence and IS) for ≥3 months and treatment exposure to vitamin K antagonists (VKAs), antiplatelet agents (APAs), or no antithrombotic medication (no-ATM). Corresponding authors provided aggregate data for IS and ICH recurrence rate between 6 weeks after the event and 1 year of follow-up for each treatment exposure. Meta-analyses of pooled rate ratios (RRs) were conducted with the inverse variance method.Results: Seventeen articles met inclusion criteria. Seven observational studies enrolling 2,452 patients were included in the meta-analysis. Pooled RR estimates for IS were lower for VKAs compared to APAs (RR = 0.45, 95% confidence interval [CI] 0.27–0.74, p = 0.002) and no-ATM (RR = 0.47, 95% CI 0.29–0.77, p = 0.002). Pooled RR estimates for ICH recurrence were not significantly increased across treatment groups (VKA vs APA: RR = 1.34, 95% CI 0.79–2.30, p = 0.28; VKA vs no-ATM: RR = 0.93, 95% CI 0.45–1.90, p = 0.84).Conclusions: In observational studies, anticoagulation with VKA is associated with a lower rate of IS than APA or no-ATM without increasing ICH recurrence significantly. A randomized controlled trial is needed to determine the net clinical benefit of anticoagulation in ICH survivors with AF.
AU  - Korompoki,E
AU  - Filippidis,FT
AU  - Nielsen,PB
AU  - Del,Giudice A
AU  - Lip,GYH
AU  - Kuramatsu,JB
AU  - Huttner,HB
AU  - Fang,J
AU  - Schulman,S
AU  - Marti-Fabregas,J
AU  - Gathier,CS
AU  - Viswanathan,A
AU  - Biffi,A
AU  - Poli,D
AU  - Weimar,C
AU  - Malzahn,U
AU  - Heuschmann,P
AU  - Veltkamp,R
DO  - 10.1212/WNL.0000000000004235
EP  - 696
PY  - 2017///
SN  - 0028-3878
SP  - 687
TI  - Long-term antithrombotic treatment in intracranial hemorrhage survivors with atrial fibrillation
T2  - NEUROLOGY
UR  - http://dx.doi.org/10.1212/WNL.0000000000004235
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000407604800014&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/51785
VL  - 89
ER  -
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