1 / 1

Association Between Sub-Therapeutic Warfarin and Intracranial Bleed Risk: Meta-Analysis Findings

This study examines the relationship between sub-therapeutic warfarin pretreatment (INR ≤ 1.7) and the risk of intracranial bleeds. Analyzing data from four studies involving 3,451 patients, we assessed bleed definitions based on NINDS, ECASS III, and modified SITS-MOST criteria. The pooled estimates indicate a significant association, with a random effects meta-analysis yielding an odds ratio of 2.20 and a fixed effect model showing an odds ratio of 1.90. Our findings provide essential insights for clinicians regarding anticoagulant management in stroke patients.

keiko-hurley
Download Presentation

Association Between Sub-Therapeutic Warfarin and Intracranial Bleed Risk: Meta-Analysis Findings

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Reference number Criteria forICH diagnosis Level of adjustment Adjusted OR (95%CI) Age DM Others AF HxStrk Sex NIHSS BP INR Case series Innsbruck NINDS  -  - - - -  - 13 NINDS    - -   - - 10 Modified SITS-MOST - - - - - - - - - 14 NINDS    -  - - - - 15 NINDS       -   16 N.R. - - - - - - - - - 17 Modified SITS-MOST - - - - - - - - - 11 N.R. - - - - - - - - - 12 ECASS - -   - -  -  Pooled estimate (random effects meta-analysis) 2.20 (0.99, 4.88) P=0.052 Pooled estimate (fixed effect meta-analysis) 1.90 (1.20, 3.01) P=0.006 I2 statistic (95%CI) 58% (11%, 80%) .01 .1 1 1 10 100 Figure e-2Adjusted random effects and fixed effect meta-analyses on the association between sub-therapeutic warfarin pre-treatment (INR≤1.7) and risk of intracranial bleedings. In four studies including 3451 patients intracranial bleedings were defined according to NINDS criteria, in one study according to ECASS III criteria (n=212), in two studies according to a modification of SITS-MOST criteria (parenchymal bleedings PH1 and PH2 with clinical deterioration ≥ 4 points on the NIHSS score) (n=391) and in two studies no information was reported on the diagnostic criteria used for the classification of bleedings (N.R.) (802 patients). Level of adjustment differs between studies and is detailed in the figure. If no adjusted ORs were presented in the publications unadjusted ORs were applied to allow comparison with the pooled estimates given in Figure 1. Abbreviations: AF, atrial fibrillation; BP, blood pressure; DM, diabetes mellitus; ECASS, The European Cooperative Acute Stroke Study; HxStrk, history of stroke; INR, international normalized ratio; NIHSS, National Institutes of Health Stroke scale; NINDS, National Institute of Neurological Disorders and Stroke; N.R., not reported; SITS-MOST, Safe Implementation of Thrombolysis in Stroke – Monitoring Study.

More Related