| Title |
Intracranial hemorrhage risk with the new oral anticoagulants: a systematic review and meta-analysis
|
|---|---|
| Published in |
Journal of Neurology, August 2014
|
| DOI | 10.1007/s00415-014-7462-0 |
| Pubmed ID | |
| Authors |
Daniel Caldeira, Márcio Barra, Fausto J. Pinto, Joaquim J. Ferreira, João Costa |
| Abstract |
The new oral anticoagulants/non-vitamin K antagonists oral anticoagulants (NOACs) have recently reached the market and less is known about their safety in comparison to their efficacy. Therefore, we aimed to evaluate intracranial hemorrhage (ICH) risk with NOACs, the most feared adverse event of anticoagulation treatment. This is a systematic review and meta-analysis of phase III randomized controlled trials (RCTs) comparing NOACs versus any control and reporting ICH events. Studies were searched through Medline and Cochrane Library (April 2014). Reviews and reference lists were also screened. Random effects' meta-analysis was performed to derive pooled estimates expressed as relative risk (RR) and 95 % CI. Number needed to treat/harm (NNT/NNH) taking into account the baseline risk was also calculated. Heterogeneity was evaluated with I (2) test. 18 RCTs evaluating 148,149 patients were included. NOAC significantly reduced ICH risk compared to vitamin K antagonists (VKA) (RR 0.44; 95 % CI 0.36-0.54; I (2) = 37 %; NNT: 137 during 2 years) and to sequential treatment with low molecular weight heparin and VKA (RR 0.28; 95 % CI 0.12-0.65; I (2) = 0 %; NNT: 463 patients during 7 months). Compared to placebo, NOACs were associated with an increased ICH risk (RR 3.31; 95 % CI 1.59-6.90; I (2) = 0 %; NNH: 433 during 1 year). Results were similar for the different NOAC drugs and across the different clinical conditions. In patients requiring anticoagulation treatment, the risk of ICH is about half with the NOACs in comparison to standard antithrombotic treatment. This safer profile found in RCTs should be confirmed in real-world database studies. |
X Demographics
The data shown below were collected from the profiles of 15 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 7 | 47% |
| Italy | 1 | 7% |
| Tunisia | 1 | 7% |
| Venezuela, Bolivarian Republic of | 1 | 7% |
| Unknown | 5 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 13 | 87% |
| Practitioners (doctors, other healthcare professionals) | 2 | 13% |
Mendeley readers
The data shown below were compiled from readership statistics for 123 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Israel | 1 | <1% |
| United States | 1 | <1% |
| Unknown | 121 | 98% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Ph. D. Student | 18 | 15% |
| Other | 14 | 11% |
| Student > Bachelor | 14 | 11% |
| Student > Master | 13 | 11% |
| Researcher | 12 | 10% |
| Other | 32 | 26% |
| Unknown | 20 | 16% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 72 | 59% |
| Pharmacology, Toxicology and Pharmaceutical Science | 5 | 4% |
| Neuroscience | 4 | 3% |
| Unspecified | 3 | 2% |
| Nursing and Health Professions | 2 | 2% |
| Other | 8 | 7% |
| Unknown | 29 | 24% |
Attention Score in Context
This research output has an Altmetric Attention Score of 10. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 March 2016.
All research outputs
#3,170,222
of 22,760,687 outputs
Outputs from Journal of Neurology
#732
of 4,466 outputs
Outputs of similar age
#33,490
of 231,195 outputs
Outputs of similar age from Journal of Neurology
#4
of 43 outputs
Altmetric has tracked 22,760,687 research outputs across all sources so far. Compared to these this one has done well and is in the 86th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,466 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.0. This one has done well, scoring higher than 83% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 231,195 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 85% of its contemporaries.
We're also able to compare this research output to 43 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 90% of its contemporaries.