Influence of antithrombotics on the etiology of intracerebral hemorrhage

Sherri A. Braksick, James P. Klaas, Robert D Jr. Brown, Alejandro Rabinstein, Sara E. Hocker, Jennifer E. Fugate

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background To determine the influence of antithrombotic use on the etiology of primary intracerebral hemorrhage (ICH). Methods We conducted a retrospective review of consecutive patients admitted with primary ICH from 2009 to 2012. Data recorded included age, history of hypertension, and use of antithrombotic medications. Imaging was reviewed to determine hemorrhage location and the presence and the location of any microhemorrhages. Etiologies were classified using a predetermined algorithm, which was based on existing literature. Results In total, 292 patients were included. Median age was 74 years (range, 18-101), and 52% were male (n = 151). Hemorrhage etiology was hypertension in 50.6% (n = 148), indeterminate in 29.5% (n = 86), and cerebral amyloid angiopathy (CAA) in 19.9% (n = 58). Most patients were on antithrombotics (61.3%, n = 179). Nearly half of the patients (49%) were 75 years of age or older, and the most common etiology in this group was hypertension (n = 77, 53%). There was a nonsignificant trend toward older age and CAA-ICH (median age, 77 years; interquartile range [IQR], 70-82 years) compared with other causes (median age, 74 years; IQR, 61-82 years; P =.07). There was no difference between CAA-ICH and other-cause ICH with respect to proportion of patients on antithrombotics in general (67% versus 60%; P =.367) or anticoagulants in particular (24% versus 25%; P = 1.000). Conclusions The most common ICH etiology in this study was hypertension, regardless of age. Our findings do not suggest that the higher occurrence of ICH in older patients or in patients with CAA-associated ICH is because of a higher frequency of anticoagulant use.

Original languageEnglish (US)
Pages (from-to)699-703
Number of pages5
JournalJournal of Stroke and Cerebrovascular Diseases
Volume24
Issue number3
DOIs
StatePublished - Mar 1 2015

Fingerprint

Cerebral Hemorrhage
Cerebral Amyloid Angiopathy
Hypertension
Anticoagulants
Hemorrhage

Keywords

  • anticoagulation
  • antiplatelet
  • antithrombotics
  • etiology
  • Intracerebral hemorrhage

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Rehabilitation
  • Cardiology and Cardiovascular Medicine

Cite this

Influence of antithrombotics on the etiology of intracerebral hemorrhage. / Braksick, Sherri A.; Klaas, James P.; Brown, Robert D Jr.; Rabinstein, Alejandro; Hocker, Sara E.; Fugate, Jennifer E.

In: Journal of Stroke and Cerebrovascular Diseases, Vol. 24, No. 3, 01.03.2015, p. 699-703.

Research output: Contribution to journalArticle

Braksick, Sherri A. ; Klaas, James P. ; Brown, Robert D Jr. ; Rabinstein, Alejandro ; Hocker, Sara E. ; Fugate, Jennifer E. / Influence of antithrombotics on the etiology of intracerebral hemorrhage. In: Journal of Stroke and Cerebrovascular Diseases. 2015 ; Vol. 24, No. 3. pp. 699-703.
@article{271e6580fb52413d8b26797f9cdd408d,
title = "Influence of antithrombotics on the etiology of intracerebral hemorrhage",
abstract = "Background To determine the influence of antithrombotic use on the etiology of primary intracerebral hemorrhage (ICH). Methods We conducted a retrospective review of consecutive patients admitted with primary ICH from 2009 to 2012. Data recorded included age, history of hypertension, and use of antithrombotic medications. Imaging was reviewed to determine hemorrhage location and the presence and the location of any microhemorrhages. Etiologies were classified using a predetermined algorithm, which was based on existing literature. Results In total, 292 patients were included. Median age was 74 years (range, 18-101), and 52{\%} were male (n = 151). Hemorrhage etiology was hypertension in 50.6{\%} (n = 148), indeterminate in 29.5{\%} (n = 86), and cerebral amyloid angiopathy (CAA) in 19.9{\%} (n = 58). Most patients were on antithrombotics (61.3{\%}, n = 179). Nearly half of the patients (49{\%}) were 75 years of age or older, and the most common etiology in this group was hypertension (n = 77, 53{\%}). There was a nonsignificant trend toward older age and CAA-ICH (median age, 77 years; interquartile range [IQR], 70-82 years) compared with other causes (median age, 74 years; IQR, 61-82 years; P =.07). There was no difference between CAA-ICH and other-cause ICH with respect to proportion of patients on antithrombotics in general (67{\%} versus 60{\%}; P =.367) or anticoagulants in particular (24{\%} versus 25{\%}; P = 1.000). Conclusions The most common ICH etiology in this study was hypertension, regardless of age. Our findings do not suggest that the higher occurrence of ICH in older patients or in patients with CAA-associated ICH is because of a higher frequency of anticoagulant use.",
keywords = "anticoagulation, antiplatelet, antithrombotics, etiology, Intracerebral hemorrhage",
author = "Braksick, {Sherri A.} and Klaas, {James P.} and Brown, {Robert D Jr.} and Alejandro Rabinstein and Hocker, {Sara E.} and Fugate, {Jennifer E.}",
year = "2015",
month = "3",
day = "1",
doi = "10.1016/j.jstrokecerebrovasdis.2014.11.009",
language = "English (US)",
volume = "24",
pages = "699--703",
journal = "Journal of Stroke and Cerebrovascular Diseases",
issn = "1052-3057",
publisher = "W.B. Saunders Ltd",
number = "3",

}

TY - JOUR

T1 - Influence of antithrombotics on the etiology of intracerebral hemorrhage

AU - Braksick, Sherri A.

AU - Klaas, James P.

AU - Brown, Robert D Jr.

AU - Rabinstein, Alejandro

AU - Hocker, Sara E.

AU - Fugate, Jennifer E.

PY - 2015/3/1

Y1 - 2015/3/1

N2 - Background To determine the influence of antithrombotic use on the etiology of primary intracerebral hemorrhage (ICH). Methods We conducted a retrospective review of consecutive patients admitted with primary ICH from 2009 to 2012. Data recorded included age, history of hypertension, and use of antithrombotic medications. Imaging was reviewed to determine hemorrhage location and the presence and the location of any microhemorrhages. Etiologies were classified using a predetermined algorithm, which was based on existing literature. Results In total, 292 patients were included. Median age was 74 years (range, 18-101), and 52% were male (n = 151). Hemorrhage etiology was hypertension in 50.6% (n = 148), indeterminate in 29.5% (n = 86), and cerebral amyloid angiopathy (CAA) in 19.9% (n = 58). Most patients were on antithrombotics (61.3%, n = 179). Nearly half of the patients (49%) were 75 years of age or older, and the most common etiology in this group was hypertension (n = 77, 53%). There was a nonsignificant trend toward older age and CAA-ICH (median age, 77 years; interquartile range [IQR], 70-82 years) compared with other causes (median age, 74 years; IQR, 61-82 years; P =.07). There was no difference between CAA-ICH and other-cause ICH with respect to proportion of patients on antithrombotics in general (67% versus 60%; P =.367) or anticoagulants in particular (24% versus 25%; P = 1.000). Conclusions The most common ICH etiology in this study was hypertension, regardless of age. Our findings do not suggest that the higher occurrence of ICH in older patients or in patients with CAA-associated ICH is because of a higher frequency of anticoagulant use.

AB - Background To determine the influence of antithrombotic use on the etiology of primary intracerebral hemorrhage (ICH). Methods We conducted a retrospective review of consecutive patients admitted with primary ICH from 2009 to 2012. Data recorded included age, history of hypertension, and use of antithrombotic medications. Imaging was reviewed to determine hemorrhage location and the presence and the location of any microhemorrhages. Etiologies were classified using a predetermined algorithm, which was based on existing literature. Results In total, 292 patients were included. Median age was 74 years (range, 18-101), and 52% were male (n = 151). Hemorrhage etiology was hypertension in 50.6% (n = 148), indeterminate in 29.5% (n = 86), and cerebral amyloid angiopathy (CAA) in 19.9% (n = 58). Most patients were on antithrombotics (61.3%, n = 179). Nearly half of the patients (49%) were 75 years of age or older, and the most common etiology in this group was hypertension (n = 77, 53%). There was a nonsignificant trend toward older age and CAA-ICH (median age, 77 years; interquartile range [IQR], 70-82 years) compared with other causes (median age, 74 years; IQR, 61-82 years; P =.07). There was no difference between CAA-ICH and other-cause ICH with respect to proportion of patients on antithrombotics in general (67% versus 60%; P =.367) or anticoagulants in particular (24% versus 25%; P = 1.000). Conclusions The most common ICH etiology in this study was hypertension, regardless of age. Our findings do not suggest that the higher occurrence of ICH in older patients or in patients with CAA-associated ICH is because of a higher frequency of anticoagulant use.

KW - anticoagulation

KW - antiplatelet

KW - antithrombotics

KW - etiology

KW - Intracerebral hemorrhage

UR - http://www.scopus.com/inward/record.url?scp=84924599919&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84924599919&partnerID=8YFLogxK

U2 - 10.1016/j.jstrokecerebrovasdis.2014.11.009

DO - 10.1016/j.jstrokecerebrovasdis.2014.11.009

M3 - Article

C2 - 25601179

AN - SCOPUS:84924599919

VL - 24

SP - 699

EP - 703

JO - Journal of Stroke and Cerebrovascular Diseases

JF - Journal of Stroke and Cerebrovascular Diseases

SN - 1052-3057

IS - 3

ER -