IR@PKUHSC  > 北京大学第三临床医学院  > 心血管内科
学科主题临床医学
Resuming anticoagulants after anticoagulation-associated intracranial haemorrhage: systematic review and meta-analysis
Zhou, Zien1,2; Yu, Jie2,3; Carcel, Cheryl2,4,5; Delcourt, Candice2,4,5; Shan, Jiehui6; Lindley, Richard I.2,5; Neal, Bruce2,7,8; Anderson, Craig S.2,4,9; Hackett, Maree L.2,5
通讯作者Zhou, Zien(1,2)
刊名BMJ OPEN
2018-05-01
DOI10.1136/bmjopen-2017-019672
8期:5
收录类别SCI
文章类型Review
WOS标题词Science & Technology
类目[WOS]Medicine, General & Internal
研究领域[WOS]General & Internal Medicine
关键词[WOS]MECHANICAL HEART-VALVES ; INTRACEREBRAL HEMORRHAGE ; ATRIAL-FIBRILLATION ; ANTITHROMBOTIC THERAPY ; ORAL ANTICOAGULATION ; BLEEDING COMPLICATIONS ; WARFARIN ; MORTALITY ; STROKE ; RISK
英文摘要

Objective To determine the adverse outcomes following resumption of anticoagulation in patients with anticoagulation-associated intracranial haemorrhage (ICH).

Design We performed a systematic review and meta-analysis in this clinical population. The Preferred Reporting Items for Systemic Reviews and Meta-Analyses statement was followed, and two authors independently assessed eligibility of all retrieved studies and extracted data.

Data sources Medline, Embase and the Cochrane Central Register of Controlled Trials, from inception to February 2017.

Eligibility criteria and outcomes Randomised controlled trials or cohort studies that recruited adults who received oral anticoagulants at the time of ICH occurrence and survived after the acute phase or hospitalisation were searched. Primary outcomes, including long-term mortality, recurrent ICH and thromboembolic events. Secondary outcomes were the frequency of resuming anticoagulant therapy and related factors.

Results We included 12 cohort studies (no clinical trials) involving 3431 ICH participants. The pooled frequency of resuming anticoagulant therapy was 38% (95% CI 32% to 44%), but this was higher in participants with prosthetic heart valves, subarachnoid haemorrhage or dyslipidaemia. There was no evidence that resuming anticoagulant therapy was associated with higher long-term mortality (pooled relative risk (RR) 0.60, 95% CI 0.30 to 1.19; p=0.14) or ICH recurrence (pooled RR 1.14, 95% CI 0.72 to 1.80; p=0.57). Resumption of anticoagulation was associated with significantly fewer thromboembolic events (pooled RR 0.31, 95% CI 0.23 to 0.42; p<0.001). In a subgroup of patients with atrial fibrillation, resuming anticoagulant therapy was associated with fewer longterm mortality (pooled RR 0.27, 95% CI 0.20 to 0.37, p<0.001).

Conclusions Based on these observational studies, resuming anticoagulant therapy after anticoagulation-associated ICH has beneficial effects on long-term complications. Clinical trials are needed to substantiate these findings.

语种英语
WOS记录号WOS:000435567200050
通讯作者邮箱zzhou@georgeinstitute.org.au
第一作者单位Shanghai Jiao Tong Univ, Sch Med, Hen Ji Hosp, Dept Radiol, South Campus, Shanghai, Peoples R China ; Univ New South Wales, Fac Med, George Inst Global Hlth, Sydney, NSW, Australia
通讯作者单位Shanghai Jiao Tong Univ, Sch Med, Hen Ji Hosp, Dept Radiol, South Campus, Shanghai, Peoples R China ; Univ New South Wales, Fac Med, George Inst Global Hlth, Sydney, NSW, Australia
ISSN2044-6055
引用统计
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/142235
专题北京大学第三临床医学院_心血管内科
作者单位1.Peking Univ, Hosp 3, Dept Cardiol, Beijing, Peoples R China;
2.Univ Sydney, Sydney Med Sch, Sydney, NSW, Australia;
3.Univ Sydney, Charles Perkins Ctr, Sydney, NSW, Australia;
4.Shanghai Jiao Tong Univ, Sch Med, Hen Ji Hosp, Dept Radiol, South Campus, Shanghai, Peoples R China;
5.Univ New South Wales, Fac Med, George Inst Global Hlth, Sydney, NSW, Australia;
6.Royal Prince Alfred Hosp, Sydney Hlth Partners, Dept Neurol, Sydney, NSW, Australia;
7.Shanghai Jiao Tong Univ, Sch Med, Ren Ji Hosp, Dept Geriatr, South Campus, Shanghai, Peoples R China;
8.Imperial Coll London, Dept Epidemiol & Biostat, London, England;
9.Peking Univ, Hlth Sci Ctr, George Inst China, Beijing, Peoples R China
推荐引用方式
GB/T 7714
Zhou, Zien,Yu, Jie,Carcel, Cheryl,et al. Resuming anticoagulants after anticoagulation-associated intracranial haemorrhage: systematic review and meta-analysis[J]. BMJ OPEN,2018,8(5).
APA Zhou, Zien.,Yu, Jie.,Carcel, Cheryl.,Delcourt, Candice.,Shan, Jiehui.,...&Hackett, Maree L..(2018).Resuming anticoagulants after anticoagulation-associated intracranial haemorrhage: systematic review and meta-analysis.BMJ OPEN,8(5).
MLA Zhou, Zien,et al."Resuming anticoagulants after anticoagulation-associated intracranial haemorrhage: systematic review and meta-analysis".BMJ OPEN 8.5(2018).
条目包含的文件
条目无相关文件。
个性服务
推荐该条目
保存到收藏夹
查看访问统计
导出为Endnote文件
谷歌学术
谷歌学术中相似的文章
[Zhou, Zien]的文章
[Yu, Jie]的文章
[Carcel, Cheryl]的文章
百度学术
百度学术中相似的文章
[Zhou, Zien]的文章
[Yu, Jie]的文章
[Carcel, Cheryl]的文章
必应学术
必应学术中相似的文章
[Zhou, Zien]的文章
[Yu, Jie]的文章
[Carcel, Cheryl]的文章
相关权益政策
暂无数据
收藏/分享
所有评论 (0)
暂无评论
 

除非特别说明,本系统中所有内容都受版权保护,并保留所有权利。