Evidence map›Paper›PMID 42240840›Full record

ArticleJournal of neurology2026

Antithrombotic therapy and risk of intracranial hemorrhage in patients with cerebral cavernous malformations: a multicenter propensity-matched cohort study.

Hamza Adel Salim, Dhairya A Lakhani, Orabi Hajjeh, Muhammed Amir Essibayi, Huanwen Chen, Aneri Balar, Nimer Adeeb, Ahmed Msherghi, Melissa Jung, Adam A Dmytriw and 7 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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

17 authors.

Hamza Adel Salim *Department of Neuroradiology, MD Anderson Medical Center, Houston, TX, 77030, USA. Hamza.sleeem@gmail.com.ORCID http://orcid.org/0000-0002-5208-8425
Dhairya A Lakhani *Department of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA. dhairyalakhani@gmail.com.
Orabi Hajjeh *Department of Neuroradiology, MD Anderson Medical Center, Houston, TX, 77030, USA.
Muhammed Amir EssibayiDepartment of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Huanwen ChenDivision of Neurointerventional Surgery, Department of Neurosurgery, University of Maryland Medical Center, Baltimore, MD, USA.
Aneri BalarDivision of Neuroradiology, Department of Radiology, Johns Hopkins Medical Center, Baltimore, MD, USA.
Nimer AdeebDepartment of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Baton Rouge, LA, USA.
Ahmed MsherghiDepartment of Neuroradiology, MD Anderson Medical Center, Houston, TX, 77030, USA.
Melissa JungDepartment of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA.
Adam A DmytriwNeuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
Marco ColasurdoDepartment of Interventional Radiology, Oregon Health and Science University, Portland, OR, 97239, USA.
Ajay MalhotraDepartment of Radiology, Yale New Haven Hospital, New Haven, CT, USA.
Dheeraj GandhiDivision of Neurointerventional Surgery, Department of Neurosurgery, University of Maryland Medical Center, Baltimore, MD, USA.
Vivek YedavalliDivision of Neuroradiology, Department of Radiology, Johns Hopkins Medical Center, Baltimore, MD, USA.
FEymen UcisikDepartment of Neuroradiology, MD Anderson Medical Center, Houston, TX, 77030, USA.
Rami W EldayaDepartment of Neuroradiology, MD Anderson Medical Center, Houston, TX, 77030, USA.
Max WintermarkDepartment of Neuroradiology, MD Anderson Medical Center, Houston, TX, 77030, USA. max.wintermark@mdanderson.org.

Funding

West Virginia IDEA-CTRU54GM104942 · NIGMS · WEST VIRGINIA UNIVERSITY · PI Sally Lynn Hodder · 2012 to 2026
$81.0M
NIGMS NIH HHS 5U54GM104942-08NIGMS NIH HHS U54 GM104942
6 · The paper itself

Abstract

backgroundThe safety of antithrombotic therapy in patients with cerebral cavernous malformations (CCMs) without prior intracranial hemorrhage (ICH) remains uncertain.

methodsWe conducted a retrospective, multicenter, propensity score-matched cohort study using the TriNetX Analytics Platform. Adult patients with CCMs and no prior ICH were included. Patients receiving antithrombotic therapy (antiplatelet or anticoagulant) were compared with those receiving no antithrombotic therapy. The primary outcome was ICH; secondary outcomes included seizures, inpatient readmission, and emergency department (ED) visits. Subgroup analyses evaluated outcomes by antithrombotic class. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated.

resultsAmong 8989 eligible patients, 1540 in each group were matched. ICH occurred more frequently in the antithrombotic group (6.3%) than in the no-therapy group (3.9%) (HR 1.77, 95% CI 1.28-2.44; log-rank p < 0.001). Seizures (18.6% vs 10.9%; HR 1.84, 95% CI 1.52-2.23), inpatient readmission (57.3% vs 31.8%; HR 2.38, 95% CI 2.13-2.65), and ED visits (39.3% vs 28.4%; HR 1.70, 95% CI 1.50-1.92) were more common. In subgroup analyses, anticoagulant use increased ICH risk (6.8% vs 3.6%; HR 2.14, 95% CI 1.31-3.51; p = 0.002), whereas antiplatelet use did not (5.2% vs 4.3%; HR 1.24, 95% CI 0.73-2.08; p = 0.424).

conclusionsIn CCM patients without prior ICH, antithrombotic therapy was associated with increased risk of ICH and other adverse outcomes, primarily driven by anticoagulants.

Indexed as

AnticoagulantsFibrinolytic AgentsHemangioma, Cavernous, Central Nervous SystemIntracranial HemorrhagesPlatelet Aggregation InhibitorsAdultAgedCohort StudiesFemaleHumansMaleMiddle AgedPropensity ScoreRetrospective StudiesAnticoagulantsFibrinolytic AgentsPlatelet Aggregation InhibitorsAnticoagulantsAntiplatelet agentsAntithrombotic therapyCerebral cavernous malformationsIntracranial hemorrhagePropensity score matching

Identifiers

PMID42240840
PMCPMC13236725

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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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.