现在的位置: 首页研究点评, 进展交流>正文
[ICU Management & Practice]: 使用非维生素K拮抗剂口服抗凝药的患者发生脑出血后的氨甲环酸治疗
2023年11月08日 研究点评, 进展交流 [ICU Management & Practice]: 使用非维生素K拮抗剂口服抗凝药的患者发生脑出血后的氨甲环酸治疗已关闭评论

Tranexamic Acid for Intracerebral Haemorrhage in Patients on NOAC

There is a lack of evidence-based haemostatic treatment for intracerebral haemorrhage (ICH) associated with non-vitamin K antagonist oral anticoagulants (NOACs). Tranexamic acid (TXA) is an antifibrinolytic drug that helps limit haematoma expansion.

A study was conducted to evaluate the effectiveness and safety of using TXA in NOAC-related ICH cases. The trial was performed at six Swiss stroke centres. The study included patients with ICH associated with NOACs who were enrolled within 12 hours of symptom onset and 48 hours of the last NOAC intake. Sixty three patients were randomly assigned to receive either intravenous TXA or a placebo alongside standard medical care. The primary outcome measure was haematoma expansion, defined as a ≥33% relative or ≥6 mL absolute increase in volume at 24 hours.

As per the findings of the study, the primary outcome, haematoma expansion, did not show a significant difference between the TXA group (n=32) and the placebo group (n=31). However, there was an indication of interaction with the time of treatment initiation, favouring TXA when administered within six hours of symptom onset.

Regarding mortality and major thromboembolic complications within 90 days, there were no significant differences between the TXA and placebo groups. Thromboembolic events occurred only in participants not restarted on oral anticoagulation, and all such events were observed at least two weeks after the study treatment.

Overall, these findings show that in patients with NOAC-associated ICH, TXA did not show evidence of preventing haematoma expansion. However, the treatment was generally safe with no major safety concerns. The results suggest that larger trials focusing on haemostatic treatments and targeting an early treatment window are required for NOAC-ICH cases.

Source: Stroke

Image Credit: iStock

«« The Promise of Artificial Intelligence in Critical Care

Ultra-Low Tidal Volume Ventilation for COVID-19-ARDS »»

References:

Polymeris AA, Karwacki GM, Siepen BM et al. (2023) Tranexamic Acid for Intracerebral Hemorrhage in Patients on Non-Vitamin K Antagonist Oral Anticoagulants (TICH-NOAC): A Multicenter, Randomized, Placebo-Controlled, Phase 2 Trial. Stroke.

Published on : Tue, 1 Aug 2023

抱歉!评论已关闭.

×
腾讯微博