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首页> 外文期刊>Cardiovascular therapeutics >Systematic review of observational research studying the long-term use of antithrombotic medicines following intracerebral hemorrhage.
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Systematic review of observational research studying the long-term use of antithrombotic medicines following intracerebral hemorrhage.

机译：对脑出血后长期使用抗栓药的观察性研究进行系统综述。

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Patients with intracerebral hemorrhage frequently have indications for antithrombotic therapy. This represents a therapeutic dilemma as intracerebral hemorrhage is considered a contraindication to antithrombotic medication. Previous systematic reviews have revealed no long-term randomised studies addressing this issue. Our objective was to review observational studies describing the long-term follow-up of patients receiving antithrombotic therapy following intracerebral hemorrhage. Searches were conducted in MEDLINE and EMBASE from 1984 to 2008 for any observational studies detailing use of antithrombotic treatments in patients with intracerebral hemorrhage. Included studies must have had follow-up extending beyond discharge. The primary endpoint was recurrent intracerebral hemorrhage. Secondary endpoints were ischemic events and serious vascular events. 1,301 articles were reviewed: two epidemiological studies and six case series met the inclusion criteria. These described a total of 46 subjects receiving antiplatelet agents (from one study) and 42 patients receiving oral anticoagulants (from one study and six case-series). For patients receiving subsequent aspirin there were seven recurrent intracerebral hemorrhages and four subsequent thrombo-occulsive events. Amongst patients restarting oral anticoagulation there were four recurrent intracerebral bleeds and nine subsequent thrombo-occulsive events. There is a marked paucity of evidence to guide clinicians when planning the long-term management of patients with intracerebral hemorrhage and cogent indications for antithrombotic therapy. Published guidance addressing this issue is not evidence based. In the continued absence of randomised studies addressing antithrombotic use following intracerebral hemorrhage, there is a clear requirement for further high quality observational data on the clinical impact of antithrombotic therapy in this important patient group.
机译：脑出血患者经常有抗血栓治疗的指征。由于脑出血被认为是抗血栓药物的禁忌证，因此这代表了治疗上的困境。先前的系统评价并未发现针对该问题的长期随机研究。我们的目的是审查观察性研究，这些研究描述了脑出血后接受抗栓治疗的患者的长期随访。 1984年至2008年在MEDLINE和EMBASE中进行了搜索，以详细了解在脑出血患者中使用抗栓治疗的任何观察性研究。纳入的研究必须进行随访，不仅限于出院。主要终点是复发性脑出血。次要终点是缺血事件和严重血管事件。审查了1,301篇文章：两项流行病学研究和六个病例系列符合纳入标准。这些描述了总共46名接受抗血小板药的受试者（来自一项研究）和42位接受口服抗凝剂的患者（来自一项研究和六个病例系列）。对于随后接受阿司匹林治疗的患者，发生了七次复发性脑出血和随后的四次血栓形成事件。在开始口服抗凝治疗的患者中，有四次复发性脑出血和随后的九次血栓形成事件。在规划脑出血和有力的抗栓治疗指征的患者的长期治疗规划时，缺乏足够的证据指导临床医生。针对此问题的已发布指南不是基于证据的。在继续缺乏针对脑出血后抗血栓形成使用的随机研究的情况下，明确需要在该重要患者组中进一步获得有关抗血栓形成治疗临床效果的高质量观​​察数据。

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