Effect of anticoagulant and antiplatelet therapy on the occurrence of primary intracerebral hemorrhage

Abstract

Introduction. The incidence of intracerebral hemorrhage related to oral anticoagulant and antiplatelet therapy has an increasing trend, thus it may be a potential indicator of unvaforable outcome of primary intracerebral hemorrhage. The aim of the study was to determine the effect of these therapies on the occurrence, localization and outcome of primary intracerebral hemorrhage. Material and Methods. A retrospective study included 246 patients with first time diagnosed primary intracerebral hemorrhage. Patients were divided into three groups, according to the drugs they have used. The incidence, anatomical distribution of primary intracerebral hemorrhage and survival/mortality rates were observed in all groups. Results. Antiplatelet therapy was used by 20.3% of patients, 8.2% received antocoagulant therapy, while the rest of 71.5% did not take these drugs in the premorbid period. The most common risk factor was arterial hypertension (97.2%). In all groups, patients had a tendency for supratentorial hematomas. Only alcohol consumption had a significant impact on the localization of hemorrhage (p < 0,05). There was no statistically significant difference between groups in National Institutes of Health Stroke Scale score on admission and a modified Rankin Scale Score at discharge. Oral anticoagulant users presented with the highest mortality rate in the first 24 hours (odds ratio - 2.5). Patients in other two groups showed a significantly higher survival rate (odds ratio - 1.5). Conclusion. Oral anticoagulant users had significantly higher National Institutes of Health Stroke Scale score on admission with an increased risk for early death. A significantly higher percentage of survival was noted in other two groups. Approximately 2/3 of all patients had poor functional recovery.