000097455 001__ 97455
000097455 005__ 20210902121916.0
000097455 0247_ $$2doi$$a10.3389/fneur.2020.594251
000097455 0248_ $$2sideral$$a121702
000097455 037__ $$aART-2020-121702
000097455 041__ $$aeng
000097455 100__ $$aRamos-Araque, M.E.
000097455 245__ $$aOral Anticoagulation and Risk of Symptomatic Hemorrhagic Transformation in Stroke Patients Treated With Mechanical Thrombectomy: Data From the Nordictus Registry
000097455 260__ $$c2020
000097455 5060_ $$aAccess copy available to the general public$$fUnrestricted
000097455 5203_ $$aIntroduction: We aimed to evaluate if prior oral anticoagulation (OAC) and its type determines a greater risk of symptomatic hemorrhagic transformation in patients with acute ischemic stroke (AIS) subjected to mechanical thrombectomy. Materials and
Methods: Consecutive patients with AIS included in the prospective reperfusion registry NORDICTUS, a network of tertiary stroke centers in Northern Spain, from January 2017 to December 2019 were included. Prior use of oral anticoagulants, baseline variables, and international normalized ratio (INR) on admission were recorded. Symptomatic intracranial hemorrhage (sICH) was the primary outcome measure. Secondary outcome was the relation between INR and sICH, and we evaluated mortality and functional outcome at 3 months by modified Rankin scale. We compared patients with and without previous OAC and also considered the type of oral anticoagulants.
Results: About 1.455 AIS patients were included, of whom 274 (19%) were on OAC, 193 (70%) on vitamin K antagonists (VKA), and 81 (30%) on direct oral anticoagulants (DOACs). Anticoagulated patients were older and had more comorbidities. Eighty-one (5.6%) developed sICH, which was more frequent in the VKA group, but not in DOAC group. OAC with VKA emerged as a predictor of sICH in a multivariate regression model (OR, 1.89 [95% CI, 1.01–3.51], p = 0.04) and was not related to INR level on admission. Prior VKA use was not associated with worse outcome in the multivariate regression model nor with mortality at 3 months.
Conclusions: OAC with VKA, but not with DOACs, was an independent predictor of sICH after mechanical thrombectomy. This excess risk was associated neither with INR value by the time thrombectomy was performed, nor with a worse functional outcome or mortality at 3 months.
000097455 536__ $$9info:eu-repo/grantAgreement/ES/ISCIII/JR19-00020$$9info:eu-repo/grantAgreement/ES/ISCIII/RD16-0019-0018$$9info:eu-repo/grantAgreement/ES/ISCIII/RD16-0019-0019$$9info:eu-repo/grantAgreement/ES/ISCIII/RD16-0019-0020$$9info:eu-repo/grantAgreement/ES/ISCIII/RD1670019-0004
000097455 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000097455 590__ $$a4.003$$b2020
000097455 591__ $$aNEUROSCIENCES$$b117 / 273 = 0.429$$c2020$$dQ2$$eT2
000097455 591__ $$aCLINICAL NEUROLOGY$$b72 / 208 = 0.346$$c2020$$dQ2$$eT2
000097455 592__ $$a1.23$$b2020
000097455 593__ $$aNeurology (clinical)$$c2020$$dQ2
000097455 593__ $$aNeurology$$c2020$$dQ2
000097455 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000097455 700__ $$aChavarría-Miranda, A.
000097455 700__ $$aGómez-Vicente, B.
000097455 700__ $$aLópez-Cancio Martínez, E.
000097455 700__ $$aCastañón Apilánez, M.
000097455 700__ $$aCastellanos, M.
000097455 700__ $$aLópez Fernández, M.
000097455 700__ $$0(orcid)0000-0002-6506-1037$$aTejada Meza, H.$$uUniversidad de Zaragoza
000097455 700__ $$0(orcid)0000-0003-3574-3034$$aMarta Moreno, J.$$uUniversidad de Zaragoza
000097455 700__ $$aTejada García, J.
000097455 700__ $$aBeltrán Rodríguez, I.
000097455 700__ $$ade la Riva, P.
000097455 700__ $$aDíez, N.
000097455 700__ $$aArias Rivas, S.
000097455 700__ $$aSantamaría Cadavid, M.
000097455 700__ $$aBravo Anguiano, Y.
000097455 700__ $$aBártulos Iglesias, M.
000097455 700__ $$aPalacio Portilla, E.J.
000097455 700__ $$aRevilla García, M.
000097455 700__ $$aTimiraos Fernández, J.J.
000097455 700__ $$aArenaza Basterrechea, N.
000097455 700__ $$aMaciñeiras Montero, J.L.
000097455 700__ $$aVicente Alba, P.
000097455 700__ $$aJulián Villaverde, F.J.
000097455 700__ $$aPinedo Brochado, A.
000097455 700__ $$aAzkune, I.
000097455 700__ $$aMar, F.M.
000097455 700__ $$aLuna, A.
000097455 700__ $$aArenillas, J.F.
000097455 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000097455 773__ $$g11 (2020), 594251 [7 pp]$$pFront. neurol.$$tFrontiers in Neurology$$x1664-2295
000097455 8564_ $$s119537$$uhttps://zaguan.unizar.es/record/97455/files/texto_completo.pdf$$yVersión publicada
000097455 8564_ $$s29195$$uhttps://zaguan.unizar.es/record/97455/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000097455 909CO $$ooai:zaguan.unizar.es:97455$$particulos$$pdriver
000097455 951__ $$a2021-09-02-10:45:51
000097455 980__ $$aARTICLE