Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Treatment of intracerebral haemorrhage with tranexamic acid – A review of current evidence and ongoing trials

Publikation: Bidrag til tidsskriftReviewForskningpeer review

DOI

  1. Therapeutic hypothermia for acute ischaemic stroke. Results of a European multicentre, randomised, phase III clinical trial

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Fourth European stroke science workshop

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. European Stroke Organisation guidelines for the management of post-stroke seizures and epilepsy

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Cognitive Assessment at Bedside for iPAD: A preliminary Validation of a Novel Cognitive test for Stroke Patients

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  • Zhe Kang Law
  • Atte Meretoja
  • Stefan T Engelter
  • Hanne Krarup Christensen
  • Eugenia-Maria Muresan
  • Solveig B Glad
  • Liping Liu
  • Philip M Bath
  • Nikola Sprigg
Vis graf over relationer
Purpose
Haematoma expansion is a devastating complication of intracerebral haemorrhage (ICH) with no established treatment. Tranexamic acid had been an effective haemostatic agent in reducing post-operative and traumatic bleeding. We review current evidence examining the efficacy of tranexamic acid in improving clinical outcome after ICH.

Method
We searched MEDLINE, EMBASE, CENTRAL and clinical trial registers for studies using search strategies incorporating the terms ‘intracerebral haemorrhage’, ‘tranexamic acid’ and ‘antifibrinolytic’. Authors of ongoing clinical trials were contacted for further details.

Findings
We screened 268 publications and retrieved 17 articles after screening. Unpublished information from three ongoing clinical trials was obtained. We found five completed studies. Of these, two randomised controlled trials (RCTs) comparing intravenous tranexamic acid to placebo (n = 54) reported no significant difference in death or dependency. Three observational studies (n = 281) suggested less haematoma growth with rapid tranexamic acid infusion. There are six ongoing RCTs (n = 3089) with different clinical exclusions, imaging selection criteria (spot sign and haematoma volume), time window for recruitment and dosing of tranexamic acid.

Discussion
Despite their heterogeneity, the ongoing trials will provide key evidence on the effects of tranexamic acid on ICH. There are uncertainties of whether patients with negative spot sign, large haematoma, intraventricular haemorrhage, or poor Glasgow Coma Scale should be recruited. The time window for optimal effect of haemostatic therapy in ICH is yet to be established.

Conclusion
Tranexamic acid is a promising haemostatic agent for ICH. We await the results of the trials before definite conclusions can be drawn.
OriginalsprogEngelsk
TidsskriftEuropean Stroke Journal
Vol/bind2
Udgave nummer1
Sider (fra-til)13-22
Antal sider10
ISSN2396-9881
DOI
StatusUdgivet - mar. 2017

ID: 49632281