ArticleNeurocritical care2025
Anticoagulant Therapy for Cerebral Venous Sinus Thrombosis: A Propensity Score Matching Study and Inverse Probability Weighting.
Article in Neurocritical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
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Corrections and comments
- Erratum issued
Authors and funding
9 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundNew oral anticoagulants (NOACs) offer potential advantages for patients with cerebral venous sinus thrombosis (CVST). There is a lack of evidence to evaluate the efficacy and safety of NOACs in CVST. The purpose of this study was to compare the benefit and safety between NOACs and warfarin in patients with CVST.
methodsWe performed a single-center prospective analysis including patients with CVST from the First Affiliated Hospital of Zhengzhou University between January 1, 2018, and December 31, 2021. The primary outcome was recurrent thrombotic events during the 6-month follow-up. Secondary outcomes included the modified Rankin scale (mRS) score, bleeding events, death, and cerebral venous recanalization during anticoagulant therapy. Propensity score matching (PSM) and inverse probability weighting (IPTW) were utilized to balance covariates between groups and mitigate selection bias in our study.
resultsA total of 650 patients were identified. NOACs were used in 184 patients, and warfarin was used in 466 patients. Baseline characteristics were balanced between groups after IPTW or PSM. After 1:2 and 1:3 PSM, there were statistically significant differences between the two groups in death (2.2% vs. 8.0%, P = 0.014) and in mRS scores ≤ 2 (95. 1% vs. 88.7%, P = 0.020) in all patients. But there were no statistically significant differences between the two groups in recurrent CVST (odds ratio [OR] 0.543; 95% confidence interval [CI] 0.258-1.143; P = 0. 108), bleeding events (OR 0.823; 95% CI 0.074-9.143; P = 0.874), and partial/complete recanalization (OR 0.980; 95% CI 0.546-1.760; P = 0.946) in all patients. Similarly, there were no significant differences in patients who received anticoagulation therapy and in patients who received endovascular therapy plus anticoagulation therapy regarding any of the clinical outcomes. These results remained similar after IPTW analysis.
conclusionsOur study demonstrates that the use of NOACs in CVST has similar efficacy and safety compared to warfarin treatment. NOACs treatment may improve the clinical prognosis in patients with CVST.
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