title: Does prior antiplatelet therapy influence hematoma volume and hematoma growth following intracerebral hemorrhage? Results from a prospective study and a meta-analysis.
abstract: Large baseline hematoma volume (HV) and hematoma growth (HG) are related to poor outcome in patients with intracerebral hemorrhage (ICH). It remains controversial whether prior antiplatelet therapy (APT) influences baseline HV and HG, and the outcome following ICH.
  
  
  
  We collected clinical and radiological data from a prospective cohort of patients diagnosed with ICH within 24 h of symptom onset. Prior APT was ascertained from the clinical history. In patients for whom a follow-up computed tomography (CT) was available within 72 h, we assessed HG, defined as an increase of ≥33% and/or ≥12.5 mL in the HV. We assessed mortality and functional outcome during follow-up with the Rankin scale. To perform a meta-analysis, we searched for published studies reporting HG according to previous APT and pooled the available data.
  
  
  
  We included 223 patients (mean age 72.5 ± 13 years). Previous APT was reported in 74 patients (33.2%). The linear regression model showed that prior APT was independently associated with larger baseline HV. HG was detected in 49 of 130 patients (37.7%) and no differences related to prior APT were observed among our cohort. However, after pooling the data of seven studies in the meta-analysis, prior APT showed an increase in HG frequency (odds ratio, 1.85; 95% confidence interval, 1.37-2.5). Patients who received APT presented with worse outcome during follow-up, although this difference was not significant (P = 0.06).
  
  
  
  In the current study, prior APT was related to larger baseline HV in patients with ICH. Data from the meta-analysis also showed a higher risk of HG associated with APT.
authors: Biomedical Research Institute Sant Pau (IIB-Sant Pau), Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors: P
authors: P
authors: Camps-Renom
authors: Biomedical Research Institute Sant Pau (IIB-Sant Pau), Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors: A
authors: A
authors: Alejaldre-Monforte
authors: Biomedical Research Institute Sant Pau (IIB-Sant Pau), Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors: R
authors: R
authors: Delgado-Mederos
authors: Biomedical Research Institute Sant Pau (IIB-Sant Pau), Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors: A
authors: A
authors: Martínez-Domeño
authors: Biomedical Research Institute Sant Pau (IIB-Sant Pau), Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors: L
authors: L
authors: Prats-Sánchez
authors: Biomedical Research Institute Sant Pau (IIB-Sant Pau), Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors: E
authors: E
authors: Pascual-Goñi
authors: Biomedical Research Institute Sant Pau (IIB-Sant Pau), Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors: J
authors: J
authors: Martí-Fàbregas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D011379:Prognosis; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: antiplatelet; hematoma growth; intracerebral hemorrhage; meta-analysis; stroke