Budinčević Hrvoje, Črnac Žuna Petra, Saleh Christian, Lange Nicholas, Piechowski-Jozwiak Bartlomiej, Bielen Ivan, Demarin Vida
Stroke and Intensive Care Unit, Department of Neurology, Sveti Duh University Hospital, Zagreb, Croatia.
School of Medicine, University J. J. Strossmayer, Osijek, Croatia.
Heliyon. 2020 Jan 27;6(1):e03219. doi: 10.1016/j.heliyon.2020.e03219. eCollection 2020 Jan.
The aim of the study was to determine the outcome, prescribed therapy, and localization of non-traumatic intracerebral haemorrhage in patients with atrial fibrillation.
This retrospective study enrolled patients with atrial fibrillation hospitalised for non-traumatic intracerebral haemorrhage from 2004 to 2013. We compared the patients according to previous antithrombotic therapy, demographics, previous CHADS2 score, comorbidities, the international normalised ration, localisation of intracerebral hamorrhage, stroke severity, prescribed antithrombotic therapy and outcome.
A total of 85 patients were enrolled and assigned to an AT+ group (n = 49; 14 on aspirin, 35 on warfarin) and an AT- group (n = 36; without antithrombotic therapy prior to hospitalisation). The latter had a lower proportion of known atrial fibrillation (90% vs 47%, < 0.001). The mean INR was 2.6 ± 1.5. The in-hospital mortality rates in both groups were high: 43% in AT+ group and 47% in AT- group. There were no significant differences in any of the predefined comparisons.
Treating patients with intracerebral haemorrhage and atrial fibrillation is challenging due to higher mortality rates and issues regarding the use of antithrombotic treatment in stroke prevention. Based on our data, prior antithrombotic therapy was not associated with increased in-hospital mortality rates or poorer functional outcome at hospital discharge in comparison with no prior antithrombotic therapy.
本研究的目的是确定心房颤动患者非创伤性脑出血的结局、规定的治疗方法及出血部位。
这项回顾性研究纳入了2004年至2013年因非创伤性脑出血住院的心房颤动患者。我们根据既往抗血栓治疗情况、人口统计学特征、既往CHADS2评分、合并症、国际标准化比值、脑出血部位、卒中严重程度、规定的抗血栓治疗方法及结局对患者进行了比较。
共纳入85例患者，分为AT+组（n = 49；14例服用阿司匹林，35例服用华法林）和AT-组（n = 36；住院前未接受抗血栓治疗）。后者已知心房颤动的比例较低（90%对47%，P<0.001）。平均国际标准化比值为2.6±1.5。两组的院内死亡率均较高：AT+组为43%，AT-组为47%。在任何预定义的比较中均无显著差异。
由于死亡率较高以及在预防卒中中使用抗血栓治疗存在问题，治疗脑出血合并心房颤动的患者具有挑战性。根据我们的数据，与未进行过抗血栓治疗相比，既往抗血栓治疗与院内死亡率增加或出院时功能结局较差无关。
