ArticleFrontiers in neurology2025
Predictors of hematoma expansion in intracerebral hemorrhage associated with factor Xa inhibitors.
Article in Frontiers in neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Improving the outcomes of patients with intracerebral hemorrhage (ICH) associated with factor Xa inhibitors remains a clinical challenge. Andexanet alfa, a specific reversal agent for factor Xa inhibitors, has the potential to mitigate hematoma expansion (HE). The aim of this study is to identify predictors of HE in ICH associated with factor Xa inhibitor use and to propose appropriate indications for reversal therapy. Methods: This was a single-center, retrospective observational study that included 68 consecutive patients who developed ICH within 24 h of factor Xa inhibitor intake and were not receiving concomitant antiplatelet therapy. The study period spanned from April 2012 to June 2022. The relationships between HE and patient-related, clinical, hematoma-related, and pharmacological factors were examined. Results: Hematoma expansion was observed in 18 cases (26.5%) and significantly worsened outcomes ( Conclusion: The predictors of HE were an irregular margin or heterogeneous hematoma, and an initial CT performed within 4 h after drug intake. Reversal decisions based on hematoma volume, or interval from onset to initial CT may be inappropriate.
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