Skip header and navigation

Refine By

15 records – page 1 of 2.

[A five-year follow-up of 115 patients treated with anticoagulants. Bleeding complications may be underestimated].

https://arctichealth.org/en/permalink/ahliterature204515
Source
Lakartidningen. 1998 Aug 26;95(35):3673-4
Publication Type
Article
Date
Aug-26-1998
Author
P. Wändell
Author Affiliation
Husläkarna i Osteråker, Akersberga, och Allmänmedicin Stockholm, Karolinska institutet, Huddinge.
Source
Lakartidningen. 1998 Aug 26;95(35):3673-4
Date
Aug-26-1998
Language
Swedish
Publication Type
Article
Keywords
Adult
Aged
Anticoagulants - adverse effects
Cerebral Hemorrhage - chemically induced - epidemiology - mortality
Female
Follow-Up Studies
Gastrointestinal Hemorrhage - chemically induced - epidemiology - mortality
Humans
Incidence
Male
Middle Aged
Sweden - epidemiology
Abstract
The prevalence of anticoagulant treatment in Sweden has increased in recent years. However, such treatment may be associated with a risk of serious complications. At 5-year follow-up of 115 primary care patients treated with anticoagulants in 1992, 39 were found to have died, eight of anticoagulant-induced bleeding complications (six of intracranial haemorrhages, and two after profuse gastro-intestinal haemorrhages). In only two of these cases, had an adverse reaction been diagnosed. The fatal complication rate was estimated to be 2.1 per cent per treatment year. There were 17 major complications requiring hospitalisation, the estimated rate being 4.4 per cent per treatment year. Three patients died of thromboembolic episodes during anticoagulant treatment, and a further three after completed treatment.
PubMed ID
9748781 View in PubMed
Less detail

Comparison of antiplatelet regimens in secondary stroke prevention: a nationwide cohort study.

https://arctichealth.org/en/permalink/ahliterature273512
Source
BMC Neurol. 2015;15:225
Publication Type
Article
Date
2015
Author
Christine Benn Christiansen
Jannik Pallisgaard
Thomas Alexander Gerds
Jonas Bjerring Olesen
Mads Emil Jørgensen
Anna Karin Numé
Nicholas Carlson
Søren Lund Kristensen
Gunnar Gislason
Christian Torp-Pedersen
Source
BMC Neurol. 2015;15:225
Date
2015
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aspirin - adverse effects
Brain Ischemia - drug therapy - epidemiology
Cerebral Hemorrhage - chemically induced - epidemiology
Cohort Studies
Denmark - epidemiology
Dipyridamole - adverse effects
Drug Therapy, Combination
Female
Humans
Male
Middle Aged
Outcome Assessment (Health Care)
Platelet Aggregation Inhibitors - adverse effects
Recurrence
Registries
Secondary Prevention
Stroke - epidemiology - prevention & control
Ticlopidine - adverse effects - analogs & derivatives
Abstract
In patients with ischemic stroke of non-cardioembolic origin, acetylsalicylic acid, clopidogrel, or a combination of acetylsalicylic acid and dipyridamole are recommended for the prevention of a recurrent stroke. The purpose of this study was to examine the risk of bleeding or recurrent stroke associated with these three treatments.
Patients who were discharged with first-time ischemic stroke from 2007-2010, with no history of atrial fibrillation were identified from Danish nationwide registries. Hazard ratios (HRs) and 1-year risks of recurrent ischemic stroke and bleeding were calculated for each antiplatelet regimen.
Among patients discharged after first-time ischemic stroke, 3043 patients were treated with acetylsalicylic acid, 12,295 with a combination of acetylsalicylic acid and dipyridamole, and 3885 with clopidogrel. Adjusted HRs for clopidogrel versus the combination of acetylsalicylic acid and dipyridamole were 1.02 (95% confidence interval [CI]: 0.89-1.17) for ischemic stroke and 1.06 (95% CI: 0.83-1.35) for bleeding. Adjusted HRs for acetylsalicylic acid versus the combination of acetylsalicylic acid and dipyridamole were 1.48 (95% CI: 1.31-1.67) for stroke and 1.47 (95% CI: 1.18-1.82) for bleeding. Clopidogrel versus acetylsalicylic acid yielded HRs of 0.69 (95% CI: 0.59-0.81) and 0.72 (95% CI: 0.55-0.96) for stroke and bleeding, respectively. The 1-year predicted risks associated with acetylsalicylic acid, the combination of acetylsalicylic acid and dipyridamole, and clopidogrel were 11.1 (95% CI: 10.2-12.2), 7.7 (95% CI: 7.3-8.3), and 8.0 (95% CI: 6.9-8.7) for ischemic stroke, respectively; while, the risks for bleeding were 3.4 (95% CI: 2.8-3.9), 2.4 (95% CI: 2.1-2.7), and 2.4 (95% CI: 1.9-2.9), respectively.
Clopidogrel and the combination of acetylsalicylic acid and dipyridamole were associated with similar risks for recurrent ischemic stroke and bleeding; whereas acetylsalicylic acid was associated with higher risks for both ischemic stroke and bleeding. The latter finding may partially be explained by selection bias.
Notes
Cites: Circulation. 2007 Nov 6;116(19):2157-6417967776
Cites: Cerebrovasc Dis. 2008;25(5):457-50718477843
Cites: N Engl J Med. 2008 Sep 18;359(12):1238-5118753638
Cites: N Engl J Med. 2008 Sep 18;359(12):1287-918753641
Cites: Scand J Public Health. 2009 Sep;37(7):758-6519622549
Cites: Stroke. 2011 Jan;42(1):227-7620966421
Cites: BMJ. 2011;342:d12421282258
Cites: Scand J Public Health. 2011 Jul;39(7 Suppl):26-921775346
Cites: Scand J Public Health. 2011 Jul;39(7 Suppl):30-321775347
Cites: Scand J Public Health. 2011 Jul;39(7 Suppl):38-4121775349
Cites: N Engl J Med. 2012 Aug 16;367(7):625-3522894575
Cites: Med Klin (Munich). 1991 Jul 15;86(7):338-431921894
Cites: Lancet. 1996 Nov 16;348(9038):1329-398918275
Cites: J Neurol Sci. 1996 Nov;143(1-2):1-138981292
Cites: Dan Med Bull. 1997 Sep;44(4):445-89377907
Cites: Lancet. 2006 May 20;367(9523):1665-7316714187
Cites: Neuroepidemiology. 2007;28(3):150-417478969
PubMed ID
26525411 View in PubMed
Less detail

Impact of prestroke selective serotonin reuptake inhibitor treatment on stroke severity and mortality.

https://arctichealth.org/en/permalink/ahliterature103115
Source
Stroke. 2014 Jul;45(7):2121-3
Publication Type
Article
Date
Jul-2014
Author
Janne Kaergaard Mortensen
Heidi Larsson
Søren Paaske Johnsen
Grethe Andersen
Author Affiliation
From the Department of Neurology, Danish Stroke Centre, (J.K.M., GA.), and Department of Clinical Epidemiology (H.L., S.P.J), Aarhus University Hospital, Aarhus, Denmark. janne.mortensen@ki.au.dk.
Source
Stroke. 2014 Jul;45(7):2121-3
Date
Jul-2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Brain Ischemia - chemically induced - epidemiology - mortality
Cerebral Hemorrhage - chemically induced - epidemiology - mortality
Denmark - epidemiology
Depression - drug therapy
Female
Follow-Up Studies
Humans
Male
Middle Aged
Propensity Score
Registries
Serotonin Uptake Inhibitors - adverse effects
Severity of Illness Index
Stroke - chemically induced - epidemiology - mortality
Young Adult
Abstract
Selective serotonin reuptake inhibitors (SSRIs) have been associated with an increased risk of bleeding but also a possible neuroprotective effect in stroke. We aimed to examine the implications of prestroke SSRI use in hemorrhagic and ischemic stroke.
We conducted a registry-based propensity score-matched follow-up study among first-ever patients with hemorrhage and ischemic stroke in Denmark (2003-2012). Multiple conditional logistic regression was used to compute adjusted odds ratios of severe stroke and death within 30 days.
Among 1252 hemorrhagic strokes (626 prestroke SSRI users and 626 propensity score-matched nonusers), prestroke SSRI use was associated with an increased risk of the strokes being severe (adjusted propensity score-matched odds ratios, 1.41; confidence interval, 1.08-1.84) and an increased risk of death within 30 days (adjusted propensity score-matched odds ratios, 1.60; confidence interval, 1.17-2.18). Among 8956 patients with ischemic stroke (4478 prestroke SSRI users and 4478 propensity score-matched nonusers), prestroke SSRI use was not associated with the risk of severe stroke or death within 30 days.
Prestroke SSRI use is associated with increased stroke severity and mortality in patients with hemorrhagic stroke. Although prestroke depression in itself may increase stroke severity and mortality, this was not found in SSRI users with ischemic stroke.
PubMed ID
24893612 View in PubMed
Less detail

Incidence and predictors of bleeding events after fibrinolytic therapy with fibrin-specific agents: a comparison of TNK-tPA and rt-PA.

https://arctichealth.org/en/permalink/ahliterature192368
Source
Eur Heart J. 2001 Dec;22(24):2253-61
Publication Type
Article
Date
Dec-2001
Author
F. Van de Werf
H V Barron
P W Armstrong
C B Granger
S. Berioli
G. Barbash
K. Pehrsson
F W Verheugt
J. Meyer
A. Betriu
R M Califf
X. Li
N L Fox
Author Affiliation
Department of Cardiology, University of Leuven, Leuven, Belgium.
Source
Eur Heart J. 2001 Dec;22(24):2253-61
Date
Dec-2001
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Alberta - epidemiology
Body Weight
California - epidemiology
Cerebral Hemorrhage - chemically induced - epidemiology
Double-Blind Method
Drug Administration Schedule
Europe - epidemiology
Female
Fibrinolytic Agents - administration & dosage - adverse effects
Hemorrhage - chemically induced - epidemiology
Humans
Incidence
Infusions, Intravenous
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction - prevention & control
North Carolina - epidemiology
Partial Thromboplastin Time
Risk factors
Sex Factors
Tissue Plasminogen Activator - administration & dosage - adverse effects
Abstract
Fibrinolytic therapy increases the risk of bleeding events. TNK-tPA (tenecteplase) is a variant of rt-PA with greater fibrin specificity and reduced plasma clearance that can be given as a single bolus. We compared the incidence and predictors of bleeding events after treatment with TNK-tPA and rt-PA.
In the Assessment of the Safety and Efficacy of a New Thrombolytic (ASSENT)-2 trial, 16 949 patients with acute myocardial infarction were randomly assigned a single weight-adjusted bolus of TNK-tPA or a 90-min infusion of rt-PA. A total of 4.66% of patients in the TNK-tPA group experienced major non-cerebral bleeding, in comparison with 5.94% in the rt-PA group (P=0.0002). This lower rate was associated with a significant reduction in the need for blood transfusion (4.25% vs 5.49%, P=0.0003) and was consistent across subgroups. Independent risk factors for major bleeding were older age, female gender, lower body weight, enrolment in the U.S.A. and a diastolic blood pressure 75 years and body weight 75 years of age who weighed
Notes
Comment In: Eur Heart J. 2001 Dec;22(24):2221-311728139
PubMed ID
11728145 View in PubMed
Less detail

[Intracranial hemorrhage--a too common adverse effect of anticoagulants?].

https://arctichealth.org/en/permalink/ahliterature231251
Source
Lakartidningen. 1989 Feb 15;86(7):535-6
Publication Type
Article
Date
Feb-15-1989

The iScore predicts effectiveness of thrombolytic therapy for acute ischemic stroke.

https://arctichealth.org/en/permalink/ahliterature127306
Source
Stroke. 2012 May;43(5):1315-22
Publication Type
Article
Date
May-2012
Author
Gustavo Saposnik
Jiming Fang
Moira K Kapral
Jack V Tu
Muhammad Mamdani
Peter Austin
S Claiborne Johnston
Author Affiliation
Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. saposnikg@smh.ca
Source
Stroke. 2012 May;43(5):1315-22
Date
May-2012
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cerebral Hemorrhage - chemically induced - epidemiology
Female
Fibrinolytic Agents - administration & dosage - adverse effects - therapeutic use
Humans
Infusions, Intravenous
Male
Middle Aged
Ontario
Outcome Assessment (Health Care) - methods
Predictive value of tests
Registries
Retrospective Studies
Risk factors
Stroke - drug therapy
Thrombolytic Therapy - methods
Tissue Plasminogen Activator - administration & dosage - adverse effects - therapeutic use
Treatment Outcome
Abstract
Tools to predict the clinical response after intravenous thrombolytic therapy (tPA) are scarce. The iScore is an existing validated tool to estimate outcomes after an acute ischemic stroke. The purpose of this study was to determine the ability of the iScore to predict clinical response and risk of hemorrhagic transformation after tPA.
We applied the iScore (www.sorcan.ca/iscore) to patients presenting with an acute ischemic stroke at 11 stroke centers in Ontario, Canada, between 2003 and 2009 identified from the Registry of the Canadian Stroke Network. A cohort of patients with stroke treated at 154 centers in Ontario was used for external validation. We compared outcomes between patients receiving and not receiving tPA after adjusting for differences in baseline characteristics using propensity-score matching. Patients were stratified into 3 a priori defined groups according to stroke severity using the iScore.
Among 12 686 patients with an acute ischemic stroke, 1696 (13.4%) received intravenous thrombolysis. Higher iScores were associated with poor outcomes in both the tPA and non-tPA groups (P
PubMed ID
22308252 View in PubMed
Less detail

[Low reporting rate of drug induced cerebral hemorrhages. Anticoagulants and NSAID suspected cause of the complication].

https://arctichealth.org/en/permalink/ahliterature166287
Source
Lakartidningen. 2006 Nov 8-14;103(45):3456-8
Publication Type
Article

Nonaspirin nonsteroidal anti-inflammatory drugs and risk of hospitalization for intracerebral hemorrhage: a population-based case-control study.

https://arctichealth.org/en/permalink/ahliterature47424
Source
Stroke. 2003 Feb;34(2):387-91
Publication Type
Article
Date
Feb-2003
Author
Søren P Johnsen
Lars Pedersen
Søren Friis
William J Blot
Joseph K McLaughlin
Jørgen H Olsen
Henrik T Sørensen
Author Affiliation
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. spj@soci.au.dk
Source
Stroke. 2003 Feb;34(2):387-91
Date
Feb-2003
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Aged, 80 and over
Anti-Inflammatory Agents, Non-Steroidal - adverse effects
Case-Control Studies
Cerebral Hemorrhage - chemically induced - epidemiology
Comorbidity
Confounding Factors (Epidemiology)
Databases, Factual - statistics & numerical data
Denmark - epidemiology
Female
Hospitalization - statistics & numerical data
Humans
Hypertension - epidemiology
Male
Middle Aged
Odds Ratio
Prescriptions, Drug - statistics & numerical data
Registries - statistics & numerical data
Research Support, Non-U.S. Gov't
Risk assessment
Sex Distribution
Abstract
BACKGROUND AND PURPOSE: Nonsteroidal anti-inflammatory drugs (NSAIDs) have effects on hemostasis and have been associated with an increased risk of bleeding. However, data relating the use of nonaspirin NSAIDs and risk of intracerebral hemorrhage (ICH) are sparse. METHODS: Using data from the County Hospital Patient Register and the Civil Registration System of North Jutland County, Denmark, we identified 912 cases of first-time ICH and 9059 sex- and age-matched population-based controls in the period of 1991 to 1999. All prescriptions for nonaspirin NSAIDs before the date of admission for ICH were identified through a population-based prescription database. Conditional logistic regression was used to adjust for potential confounding factors, including previous discharge diagnoses of hypertension, chronic bronchitis and emphysema, alcoholism, liver cirrhosis, diabetes mellitus, and prescriptions for insulin or oral hypoglycemic agents, antihypertensive agents, lipid-lowering agents, low-dose aspirin, high-dose aspirin, and oral anticoagulants. RESULTS: No overall association was found between prescription for nonaspirin NSAIDs in the preceding 30, 60, or 90 days and risk of ICH; ie, odds ratios ranged from 0.92 (95% CI, 0.70 to 1.21) to 1.13 (95% CI, 0.81 to 1.58). Furthermore, there was no increased risk of ICH associated with prescription for nonaspirin NSAIDs when the study population was stratified by age, sex, and a previous discharge diagnosis of hypertension. CONCLUSIONS: Patients prescribed nonaspirin NSAIDs were not at an overall increased risk of being hospitalized for ICH. This reassuring finding was seen in all examined subgroups, including the elderly and patients with a previous discharge diagnosis of hypertension.
Notes
Comment In: Stroke. 2003 Jun;34(6):e34-6; author reply e34-612750529
PubMed ID
12574547 View in PubMed
Less detail

Nonsteroidal anti-inflammatory drugs and the risk of intracerebral hemorrhage.

https://arctichealth.org/en/permalink/ahliterature186735
Source
Stroke. 2003 Feb;34(2):379-86
Publication Type
Article
Date
Feb-2003

15 records – page 1 of 2.