title: Pretreatment with antiplatelet agents is not independently associated with unfavorable outcome in intracerebral hemorrhage.
abstract: OBJECTIVE
  This study investigated the effect of preexisting antiplatelet therapy on mortality and functional outcome in patients with intracerebral hemorrhage (ICH).
  
  
  METHODS
  Our analysis was based on a large, country-wide stroke registry in Germany. All parameters relevant to this analysis, including age, prehospital status (according to the modified Rankin Scale, mRS), International Classification of Diseases-based diagnosis, and pretreatment with antiplatelet agents or oral anticoagulants, were recorded prospectively. Main outcome measures were in-hospital mortality rate and functional status at hospital discharge (mRS).
  
  
  RESULTS
  Over a 2-year period, 1691 patients with ICH (ICD-10: I61) were documented (48% female; mean age, 72+/-12 years). At symptom onset, 26% were taking antiplatelet agents, and 12% were taking oral anticoagulants. By univariate logistic regression, pretreatment with antiplatelet drugs or anticoagulants was found to be a significant predictor of in-hospital mortality (odds ratio [OR], 1.42; P=0.008; OR, 1.53; P<0.001) and of an unfavorable functional outcome (defined as mRS >2 or death; OR, 1.33, P=0.039; OR, 1.51; P<0.001). However, after adjustment for age and prehospital status, antiplatelet pretreatment was no longer an independent risk factor of in-hospital death (OR, 1.12; P=0.490) or unfavorable functional outcome (OR, 0.97; P=0.830), whereas the influence of pretreatment with oral anticoagulants remained significant (OR, 1.45; P<0.001; OR, 1.42; P=0.009).
  
  
  CONCLUSIONS
  In contrast to oral anticoagulants, pretreatment with antiplatelet agents is not an independent risk factor of mortality and unfavorable outcome in patients with ICH.
authors.affiliation: Department of Neurology, Johann Wolfgang Goethe University, Schleusenweg 2-16, 60528 Frankfurt am Main, Germany. foerch@em.uni-frankfurt.de
authors.forename: Christian
authors.initials: C
authors.lastname: Foerch
authors.forename: Matthias
authors.initials: M
authors.lastname: Sitzer
authors.forename: Helmuth
authors.initials: H
authors.lastname: Steinmetz
authors.forename: Tobias
authors.initials: T
authors.lastname: Neumann-Haefelin
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000401:mortality* / Q000503:physiopathology*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D011379:Prognosis; D012042:Registries
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors