Abstract
Objectives
This study aimed to determine the impact of the approval of prothrombin complex concentrates
on the treatment of vitamin K antagonist-related intracerebral hemorrhage.
Materials and Methods
We retrospectively studied all patients with vitamin K antagonist-related intracerebral
hemorrhage treated with prothrombin complex concentrate at our institutes between
January 2010 and June 2021. Before approval, prothrombin complex concentrate was administered
as either 500 or 1000 IU at the physician's discretion (previous dose group). After
approval, we adopted the manufacturer's recommended regimen (recommended dose group).
The primary outcome was post-administration international normalized ratio. Secondary
outcomes were the amount of prothrombin complex concentrate administered and proportion
of post-administration international normalized ratio <1.5, hematoma expansion, thrombotic
events within 30 days, modified Rankin scale 0–3 at discharge, and in-hospital mortality.
Results
Thirty-two and 19 patients in the previous and recommended dose groups, respectively,
were included. The post-administration international normalized ratio significantly
differed between groups. The prothrombin complex concentrate dose and proportion of
patients achieving post-administration international normalized ratio <1.5 were significantly
higher in the recommended dose group than in the previous dose group (1500 IU vs.
500 IU, p<0.001 and 100% vs. 68%, p = 0.008). The proportions of hematoma expansion, thromboembolic events, modified
Rankin scale 0-3, and mortality did not differ between groups.
Conclusion
After prothrombin complex concentrate approval, prothrombin time-international normalized
ratio correction was more effective with a significant increase in the prothrombin
complex concentrates dose for vitamin K antagonist-associated intracerebral hemorrhage;
however, there was no apparent difference in clinical outcomes.
Key Words
Abbreviations:
VKA (vitamin K antagonist), ICH (intracerebral hemorrhage), pcc (prothrombin complex concentrate)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 27, 2022
Accepted:
October 24,
2022
Received:
September 2,
2022
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106861
Copyright
© 2022 Elsevier Inc. All rights reserved.