スダ　サトシ   SUDA Satoshi   須田　智    所属   埼玉医科大学  医学部 国際医療センター　神経内科・脳卒中内科    職種   教授
論文種別	学術雑誌(原著)
言語種別	英語
査読の有無	査読あり
表題	Low risk of ICH after reperfusion therapy in acute stroke patients treated with direct oral anti-coagulant
掲載誌名	正式名：JOURNAL OF THE NEUROLOGICAL SCIENCES ISSNコード：0022-510X/1878-5883
出版社	ELSEVIER SCIENCE BV
巻・号・頁	379,207-211頁
著者・共著者	Kentaro Suzuki,Junya Aoki,Yuki Sakamoto,Arata Abe,Satoshi Suda,Seiji Okubo,Takehiko Nagao,Kazumi Kimura
発行年月	2017/08
概要	Background: The safety of intravenous thrombolysis (IVT) and endovascular therapy (EVT) in patients treated with DOAC is unclear. We investigated whether recanalization therapy in patients treated with DOAC is safe. Methods: A nationwide, multicenter, retrospective cohort questionnaire survey was conducted to investigate the: (1) frequency of intracerebral hemorrhage (ICH) after recanalization therapy in patients treated with DOAC; (2) independent factors related to ICH; (3) relationship between last intake time of DOAC and ICH; and (4) comparison of ICH frequency between patients treated with DOAC, vitamin K antagonist (VKA), and no-anticoagulation (no-ACT) (control). Results: One hundred eighteen stroke centers returned the questionnaire and 100 patients (56 IVT alone, 29 EVT alone, and 15 both IVT and EVT) on DOAC were registered. The frequency of asymptomatic and symptomatic (>=. 4-point NIHSS score increase) ICH within 24 h in DOAC patients were 18% and 2%, and were not different compared with the VKA and no-ACT groups (p = 0.728; and p = 0.626). On multivariate analysis, systolic blood pressure (OR, 1.04; p<0.001) and blood glucose (OR, 1.02; p = 0.019) were independent factors for ICH. Among the 52 patients with a known last intake time of DOAC, the rate of ICH was higher in patients 54 h from last intake than those >4 h (38% vs. 10%, p = 0.033). Conclusions: Risk of ICH after reperfusion therapy in patients treated with DOAC should be low. Systolic blood pressure, glucose level, and DOAC intake time appear to be factors for ICH. (C) 2017 Elsevier B.V. All rights reserved.
DOI	10.1016/j.jns.2017.06.004
PMID	28716241