title: Do the antithrombotic therapy at the time of intracerebral hemorrhage influence clinical outcome? analysis between the difference of antiplatelet and anticoagulant agents and clinical course.
abstract: BACKGROUND
  It is controversial whether taking antiplatelet agents (APs) or anticoagulant agents (ACs) could influence clinical outcome after intracerebral hemorrhage (ICH).
  
  
  METHODS
  We retrospectively investigated 557 ICH patients between September 2008 and August 2013. We reviewed patients' characteristics, hematoma volume, deterioration (hematoma expansion, surgical hematoma evacuation, or death), and clinical outcome in modified Rankin Scale.
  
  
  RESULTS
  A total of 397 were classified as neither AP nor AC ("Nothing"), 81 as single AP (44 as aspirin [ASA], 22 as clopidogrel or ticlopidine [CLP/TIC], 7 as cilostazol, 8 as dual antiplatelet therapy), 43 as single AC (40 as warfarin, 2 as rivaroxaban, 1 as dabigatran), and 36 as both AP and AC (AP + AC). The clinical outcome was worse in APs than in "Nothing" (P = .021). Among APs, CLP/TIC showed poorer clinical outcome than ASA (P = .020). Deterioration was observed more frequently in AC than in "Nothing" (P < .001) and the clinical outcome was also worse in AC than in "Nothing" (P < .001). AP + AC use resulted in deterioration more frequently than "Nothing" (P < .001) and in poorer outcome than in "Nothing" (P < .001).
  
  
  CONCLUSIONS
  The use of antithrombotic agents could be associated with the deterioration after admission and the poor clinical outcome. CLP/TIC use may affect the poor outcome compared with ASA use.
authors: Department of Surgical Neurology, Research Institute for Brain and Blood Vessels Akita, Akita, Japan. Electronic address: t-okada@akita-noken.jp.
authors: Takeshi
authors: T
authors: Okada
authors: Department of Stroke Science, Research Institute for Brain and Blood Vessels Akita, Akita, Japan.
authors: Taizen
authors: T
authors: Nakase
authors: Department of Stroke Science, Research Institute for Brain and Blood Vessels Akita, Akita, Japan.
authors: Masahiro
authors: M
authors: Sasaki
authors: Department of Surgical Neurology, Research Institute for Brain and Blood Vessels Akita, Akita, Japan.
authors: Tatsuya
authors: T
authors: Ishikawa
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D002543:Cerebral Hemorrhage / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors
keywords: Intracerebral hemorrhage; anticoagulant; antiplatelet; clinical outcome