Evidence map›Paper›PMID 40001238›Full record

SynthesisEuropean journal of medical research2025

Tranexamic acid in spontaneous intracerebral hemorrhage: a meta-analysis.

Yu Chang, Pei-Chun Lai, Chih-Yuan Huang, Junmin Song, Kuan-Yu Chi, Hsiang-Yi Hung, Yen-Ta Huang

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
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Synthesis in European journal of medical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Review
  2. Review
  3. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Yu ChangDepartment of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Pei-Chun LaiEducation Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Chih-Yuan HuangDepartment of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Junmin SongDepartment of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Kuan-Yu ChiDepartment of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Hsiang-Yi HungDepartment of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Yen-Ta HuangDepartment of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. uncleda.huang@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSpontaneous intracerebral hemorrhage (sICH) is a critical and disabling form of stroke and accounts for an obvious number of stroke-related deaths and disabilities globally. Hematoma growth is a key target for therapeutic intervention because of its association with poor outcomes. Recently, the STOP-MSU trial showed that intravenous tranexamic acid (TA) did not reduce hematoma growth or improve clinical outcomes when administered within 2 h of intracerebral hemorrhage symptom onset. This study aims to evaluate the efficacy of TA in reducing hematoma growth and improving clinical outcomes in patients with spontaneous sICH by incorporating the findings from the latest STOP-MSU trial and consolidating past research to clarify the overall efficacy and safety of TA on sICH.

methodsA systematic review and meta-analysis were conducted according to the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA guidelines. We included randomized controlled trials (RCTs) comparing TA to placebo in adult patients with sICH. Databases such as PubMed, Medline, and Cochrane were searched up to May 2024. Key outcomes analyzed included hematoma expansion, mortality within 90 days, thromboembolic events, and favorable functional outcomes. Data were pooled using a random-effects model and analyzed using the "metafor" package in RStudio.

resultsFive RCTs involving 1419 patients were included. The meta-analysis showed no significant difference in hematoma expansion (odds ratio [OR] 0.87, 95% confidence interval [CI] 0.74-1.03), mortality within 90 days (OR 1.03, 95% CI 0.86-1.24), thromboembolic events (OR 1.07, 95% CI 0.69-1.64), and favorable functional outcomes (modified Rankin Scale of 0-2 at 90 days; OR 1.04, 95% CI 0.88-1.22) between the TA and placebo groups.

conclusionsTA does not significantly reduce hematoma growth or improve clinical outcomes in patients with sICH. Despite its affordability and availability, the routine use of TA in sICH is not supported by current evidence.

Indexed as

Antifibrinolytic AgentsCerebral HemorrhageTranexamic AcidHematomaHumansRandomized Controlled Trials as TopicTreatment OutcomeAntifibrinolytic AgentsTranexamic Acid

Identifiers

PMID40001238
PMCPMC11854317

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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.