Lacut Karine, Le Gal Gregoire, Seizeur Romuald, Prat Gwenael, Mottier Dominique, Oger Emmanuel
Department of Internal Medicine and Chest Diseases, G.E.T.B.O. (Groupe d'Etude de la Thrombose de Bretagne Occidentale), Brest Cedex, France.
Fundam Clin Pharmacol. 2007 Jun;21(3):327-33. doi: 10.1111/j.1472-8206.2007.00488.x.
Recent studies highlight the contribution of antiplatelet therapy to clinical severity and increased mortality of intracerebral hemorrhage (ICH) but results are discrepant. The aim of this report was to evaluate the association between antiplatelet drug use preceding the onset of ICH and the mortality, assessed at regular intervals, among patients with acute ICH. We analyzed data from a randomized study which enrolled consecutive patients with a documented acute ICH to evaluate the efficacy of intermittent pneumatic compression of the legs in venous thrombosis prevention. Clinical characteristics and treatment used before the onset of ICH were checked at the time of inclusion. Mortality was assessed at regular intervals until 3 months after ICH diagnosis. Among 138 patients included in this report, 30 were current users of antiplatelet therapy at the time of ICH; they were significantly older and less frequently heavy drinkers than non-users of antiplatelet drugs. Mortality rates were 20% at 8 days, 40% at 1 month, and 47% at 3 months among antiplatelet drug users compared with 6.5%, 13% and 19% among non-users. The corresponding estimated risks for mortality related to antiplatelet drug use were 3.6 (95% CI 1.1-12), 4.5 (95% CI 1.8-11), and 3.6 (95% CI 1.5-8.6). Adjusted for age, hypertension and alcohol over use, antiplatelet therapy remained significantly associated with an increased mortality rate of acute ICH. Current antiplatelet drug use preceding the onset of ICH is associated with increased short-term ICH mortality, independently of age.
近期研究强调了抗血小板治疗对脑出血（ICH）临床严重程度及死亡率增加的影响，但结果存在差异。本报告的目的是评估ICH发病前使用抗血小板药物与急性ICH患者定期评估的死亡率之间的关联。我们分析了一项随机研究的数据，该研究纳入了连续的有记录的急性ICH患者，以评估腿部间歇性气动压迫预防静脉血栓形成的疗效。在纳入研究时检查了ICH发病前的临床特征和治疗情况。定期评估死亡率，直至ICH诊断后3个月。在本报告纳入的138例患者中，30例在ICH发生时正在使用抗血小板治疗；与未使用抗血小板药物的患者相比，他们年龄更大，酗酒者更少。抗血小板药物使用者在8天时的死亡率为20%，1个月时为40%，3个月时为47%，而未使用者分别为6.5%、13%和19%。与使用抗血小板药物相关的相应估计死亡风险为3.6（95%CI 1.1 - 12）、4.5（95%CI 1.8 - 11）和3.6（95%CI 1.5 - 8.6）。在调整年龄、高血压和过量饮酒因素后，抗血小板治疗仍与急性ICH死亡率增加显著相关。ICH发病前当前使用抗血小板药物与短期ICH死亡率增加相关，与年龄无关。
