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Feb 20, 2025;

Safety Study of Anticoagulants for Preventing Deep Venous Thrombosis after Intracerebral Hemorrhage: Data from the Chinese Stroke Center Alliance.

Ping Lu, Lingyun Cui, Hongqiu Gu, Zixiao Li, Yongjun Wang, Xingquan Zhao
Author Information
  1. Ping Lu: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, 119# Nan Si Huan Xi Lu, Beijing, 100070, People's Republic of China.
  2. Lingyun Cui: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, 119# Nan Si Huan Xi Lu, Beijing, 100070, People's Republic of China.
  3. Hongqiu Gu: China National Clinical Research Center for Neurological Diseases, Capital Medical University, Beijing, People's Republic of China.
  4. Zixiao Li: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, 119# Nan Si Huan Xi Lu, Beijing, 100070, People's Republic of China.
  5. Yongjun Wang: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, 119# Nan Si Huan Xi Lu, Beijing, 100070, People's Republic of China.
  6. Xingquan Zhao: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, 119# Nan Si Huan Xi Lu, Beijing, 100070, People's Republic of China. zxq@vip.163.com.
PMID: 39979772 DOI: 10.1007/s40266-025-01187-4

Abstract

OBJECTIVE: The use of anticoagulants to prevent deep vein thrombosis (DVT) after intracerebral hemorrhage (ICH) remains controversial. This study aims to evaluate the safety of anticoagulants in preventing DVT in patients with ICH.
METHODS: Data were sourced from the Chinese Stroke Center Alliance. The primary outcomes include in-hospital mortality, intracranial hematoma evacuation, and hematoma expansion. Absolute standardized differences (ASD) are used to assess differences between groups, and multivariate logistic regression analysis is employed to analyze correlations. Platelet counts and international normalized ratio (INR) were examined within subgroups. Propensity score matching (PSM) is used for sensitivity analysis.
RESULTS: A total of 56,633 patients with ICH were finally enrolled. Multivariate logistic regression analysis revealed that anticoagulant use correlated with reduced in-hospital mortality and hematoma expansion (OR: 0.59, 95% CI: 0.50-0.69, p < 0.001 and OR: 0.55, 95% CI: 0.41-0.73, p < 0.001), while no association was observed with intracranial hematoma evacuation clearance (OR: 1.00, 95% CI: 0.93-1.08, p = 0.941). Subgroup analysis revealed an increased risk of intracranial hematoma evacuation with anticoagulant use when INR >1.7 (OR: 1.47, 95% CI: 1.15-1.89, p = 0.002), but not of in-hospital mortality (OR: 1.20, 95% CI: 0.78-1.85, p = 0.409) or hematoma expansion (OR: 0.66, 95% CI: 0.19-2.25, p = 0.503). PSM yielded consistent outcomes.
CONCLUSIONS: Post-ICH anticoagulant therapy to prevent DVT is safe, posing no heightened risk of in-hospital mortality, intracranial hematoma evacuation, or hematoma expansion. However, caution is warranted in patients with coagulopathies.

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Grants

  1. 2022ZD0118005/the National Key R&D Program of China
  2. 2019-I2M-5-029/the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences
  3. 2020-1-2041/The Capital's Funds for Health Improvement and Research
Journal Article

Word Cloud

Created with Highcharts 10.0.00hematomaOR:95%CI:pin-hospitalmortalityintracranialevacuationexpansionanalysis1=useDVTICHpatientsanticoagulantanticoagulantspreventDataChineseStrokeCenterAllianceoutcomesdifferencesusedlogisticregressionINRPSMrevealed<001riskOBJECTIVE:deepveinthrombosisintracerebralhemorrhageremainscontroversialstudyaimsevaluatesafetypreventingMETHODS:sourcedprimaryincludeAbsolutestandardizedASDassessgroupsmultivariateemployedanalyzecorrelationsPlateletcountsinternationalnormalizedratioexaminedwithinsubgroupsPropensityscorematchingsensitivityRESULTS:total56633finallyenrolledMultivariatecorrelatedreduced5950-0695541-073associationobservedclearance0093-108941Subgroupincreased>174715-1890022078-1854096619-225503yieldedconsistentCONCLUSIONS:Post-ICHtherapysafeposingheightenedHowevercautionwarrantedcoagulopathiesSafetyStudyAnticoagulantsPreventingDeepVenousThrombosisIntracerebralHemorrhage:

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