Evidence map›Paper›PMID 32500220›Full record

ArticleJournal of thrombosis and thrombolysis2021

Treatment of adults with intracranial hemorrhage on apixaban or rivaroxaban with prothrombin complex concentrate products.

Renee Castillo, Alissa Chan, Steven Atallah, Katrina Derry, Mark Baje, Lara L Zimmermann, Ryan Martin, Leonid Groysman, Sara Stern-Nezer, Anush Minokadeh and 4 more

Erratum issuedOpen access · hybridAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of thrombosis and thrombolysis, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 13 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 2 pooled it
3.7field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 40 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Clinical Management of Cerebral Amyloid Angiopathy.Journal of clinical medicine · 2025
    Review
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  9. Observational
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 4 institutions in 1 country.

Renee CastilloDepartment of Pharmacy, University of California, Irvine Health, Orange, CA, USA.
Alissa ChanDepartment of Pharmacy, University of California San Diego Health, San Diego, CA, USA.
Steven AtallahDepartment of Pharmacy, University of California, Irvine Health, Orange, CA, USA.
Katrina DerryDepartment of Pharmacy, University of California San Diego Health, San Diego, CA, USA.
Mark BajeDepartment of Pharmacy, University of California, Irvine Health, Orange, CA, USA.
Lara L ZimmermannDepartment of Neurological Surgery and Neurology, University of California Davis Health, Sacramento, CA, USA.
Ryan MartinDepartment of Neurological Surgery and Neurology, University of California Davis Health, Sacramento, CA, USA.
Leonid GroysmanDepartment of Neurology, University of California, Irvine Health, Orange, CA, USA.
Sara Stern-NezerDepartment of Neurology, University of California, Irvine Health, Orange, CA, USA.
Anush MinokadehDepartment of Critical Care, University of California San Diego Health, San Diego, CA, USA.
Alan NovaDepartment of Critical Care, University of California San Diego Health, San Diego, CA, USA.
WanTing HuangDepartment of Pharmacy, University of California San Diego Health, San Diego, CA, USA.
William CangDepartment of Pharmacy, University of California San Diego Health, San Diego, CA, USA.
Kendra SchomerDepartment of Pharmacy, University of California Davis Health, Sacramento, CA, USA. kjschomer@ucdavis.edu.ORCID http://orcid.org/0000-0002-5554-9039
UC San Diego Health System · USUniversity of California, Irvine · USNeurological Surgery · USUniversity of California System · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

To analyze the efficacy and safety of activated prothrombin complex concentrates (aPCC) and four-factor prothrombin complex concentrates (4F-PCC) to prevent hematoma expansion in patients taking apixaban or rivaroxaban with intracranial hemorrhage (ICH). In this multicenter, retrospective study, sixty-seven ICH patients who received aPCC or 4F-PCC for known use of apixaban or rivaroxaban between February 2014 and September 2018 were included. The primary outcome was the percentage of patients who achieved excellent/good or poor hemostasis after administration of aPCC or 4F-PCC. Secondary outcomes included hospital mortality, thromboembolic events during admission, and transfusion requirements. Excellent/good hemostasis was achieved in 87% of aPCC patients, 89% of low-dose 4F-PCC [< 30 units per kilogram (kg)], and 89% of high-dose 4F-PCC (≥ 30 units per kg). There were no significant differences in excellent/good or poor hemostatic efficacy (p = 0.362). No differences were identified in transfusions 6 h prior (p = 0.087) or 12 h after (p = 0.178) the reversal agent. Mortality occurred in five patients, with no differences among the groups (p = 0.838). There were no inpatient thromboembolic events. Both aPCC and 4F-PCC appear safe and equally associated with hematoma stability in patients taking apixaban or rivaroxaban who present with ICH. Prospective studies are needed to identify a superior reversal agent when comparing andexanet alfa to hospital standard of care (4F-PCC or aPCC) and to further explore the optimal dosing strategy for patients with ICH associated with apixaban or rivaroxaban use.

Indexed as

AgedAged, 80 and overBlood Coagulation FactorsFactor Xa InhibitorsFemaleHumansIntracranial HemorrhagesMaleMiddle AgedPyrazolesPyridonesRivaroxabanTreatment OutcomeapixabanBlood Coagulation FactorsFactor Xa Inhibitorsprothrombin complex concentratesPyrazolesPyridonesRivaroxabanDirect oral anticoagulantsFactor xa inhibitorsHematomasHemostaticsIntracranial hemorrhagesProthrombin complex concentrates

Identifiers

PMID32500220
PMCPMC7829230
OpenAlexW3033329270

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.