title: Antithrombotic therapy influences location, enlargement, and mortality from intracerebral hemorrhage. The Bleeding with Antithrombotic Therapy (BAT) Retrospective Study.
abstract: BACKGROUND
  To determine whether the use of oral antithrombotic agents before the onset of intracerebral hemorrhage (ICH) affects hematoma features and early patient outcome.
  
  
  METHODS
  A retrospective, multicenter study involving 1,006 consecutive Japanese patients (607 men, 67 +/- 12 years of age) hospitalized within 24 h after the onset of nontraumatic ICH was conducted.
  
  
  RESULTS
  One hundred and eighty patients were taking oral antiplatelet agents (17.9%, AP group), 67 were taking warfarin (6.7%, W group), and 21 were taking both (2.1%, W + AP group). After adjustment for age, sex, and known confounders, the taking of each kind of antithrombotic therapy was independently related to cerebellar hemorrhage; the odds ratios (OR) and 95% CI, with patients taking no antithrombotic agents as the reference group, were 2.31 (1.23-4.32) for the AP group, 2.90 (1.26-6.63) for the W group, and 3.43 (1.02-11.59) for the W + AP group. Similarly, the taking of each kind of antithrombotic therapy was independently related to hematoma enlargement within the initial 24 h (OR and 95% CI: AP group, 1.92, 1.10-3.34; W group, 4.80, 2.12-10.87; W + AP group, 4.94, 1.31-18.61) and mortality at 3 weeks post-ICH (OR and 95% CI: AP group, 2.70, 1.56-4.68; W group, 2.50, 1.05-5.96; W + AP group, 9.41, 2.78-31.88).
  
  
  CONCLUSIONS
  Prior medication with antiplatelet agents, warfarin, or both was predictive of cerebellar hemorrhage, hematoma enlargement, and early death in Japanese ICH patients.
authors.affiliation: Cerebrovascular Division, Department of Medicine, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, Japan. toyoda@ hsp.ncvc.go.jp
authors.forename: Kazunori
authors.initials: K
authors.lastname: Toyoda
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yasaka
authors.forename: Ken
authors.initials: K
authors.lastname: Nagata
authors.forename: Takehiko
authors.initials: T
authors.lastname: Nagao
authors.forename: Jun
authors.initials: J
authors.lastname: Gotoh
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Uchiyama
authors.forename: Kazuo
authors.initials: K
authors.lastname: Minematsu
mesh_terms: D000284:Administration, Oral; D000368:Aged; D002543:Cerebral Hemorrhage / Q000139:chemically induced* / Q000401:mortality*; D004359:Drug Therapy, Combination; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D006406:Hematoma / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014859:Warfarin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin