期刊
STROKE
卷 44, 期 9, 页码 2422-2426出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/STROKEAHA.111.000811
关键词
anticoagulant; coumarin; phenprocoumon; platelet aggregation inhibitors
Background and Purpose Subarachnoid hemorrhage (SAH) accounts for <7% of all strokes, but is an enormous individual and societal burden. We investigated the risk of SAH associated with prior use of antithrombotic drugs and their influence on 30-day case fatality. Methods We conducted a nested case-control study in a cohort of 13.4 million members of the German Pharmacoepidemiological Research Database. Ten controls were matched to each case hospitalized for SAH between July 2004 and November 2006 by health insurance, year of birth, and sex using risk set sampling. Exposure was assessed for the warfarin analog phenprocoumon, heparin, clopidogrel/ticlopidine, and acetylsalicylic acid. Multivariable-adjusted odds ratios (ORs) for SAH were estimated by conditional logistic regression. Risk factors for 30-day case fatality were assessed in patients with SAH by logistic regression. Results The nested case-control study included 2065 SAH cases and 20649 matched controls. The risk of SAH was significantly increased for phenprocoumon (OR, 1.7; 95% confidence interval [CI], 1.3-2.3), clopidogrel/ticlopidine (OR, 1.7; 95% CI, 1.1-2.5), and for acetylsalicylic acid use (OR, 1.5; 95% CI, 1.2-2.0), but not for outpatient heparin use (OR, 1.2; 95% CI, 0.5-2.7). The early case fatality of 22.8% was associated with an age >70 years (OR, 2.3; 95% CI, 1.8-3.1) and arterial hypertension (OR, 1.3; 95% CI, 1.0-1.6), but not with any of the antithrombotic drugs. Conclusions Outpatient antithrombotic drug use was associated with an increased risk of SAH, but no association was observed with early case fatality.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据