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Prophylactic anticoagulation in patients with glioblastoma or brain metastases and atrial fibrillation: an increased risk for intracranial hemorrhage?

Purpose  Patients with glioblastoma (GBM) or brain metastases (MET) and atrial fibrillation (AF) might be at an increased risk of intracranial hemorrhage (ICH) due to anticoagulation (AC). Our aim was to assess this risk. - Methods  Our institution’s database (from 2005 to 2017) was screened for pat...

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Hauptverfasser: Burth, Sina (VerfasserIn) , Ohmann, Mona (VerfasserIn) , Kronsteiner, Dorothea (VerfasserIn) , Kieser, Meinhard (VerfasserIn) , Löw, Sarah (VerfasserIn) , Riedemann, Lars (VerfasserIn) , Laible, Mona (VerfasserIn) , Berberich, Anne (VerfasserIn) , Drüschler, Katharina (VerfasserIn) , Rizos, Timolaos (VerfasserIn) , Wick, Antje (VerfasserIn) , Winkler, Frank (VerfasserIn) , Wick, Wolfgang (VerfasserIn) , Nagel, Simon (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 5 March 2021
In: Journal of neuro-oncology
Year: 2021, Jahrgang: 152, Heft: 3, Pages: 483-490
ISSN:1573-7373
DOI:10.1007/s11060-021-03716-8
Online-Zugang:Verlag, kostenfrei, Volltext: https://doi.org/10.1007/s11060-021-03716-8
Verlag, kostenfrei, Volltext: https://link.springer.com/10.1007/s11060-021-03716-8
Volltext
Verfasserangaben:Sina Burth, Mona Ohmann, Dorothea Kronsteiner, Meinhard Kieser, Sarah Löw, Lars Riedemann, Mona Laible, Anne Berberich, Katharina Drüschler, Timolaos Rizos, Antje Wick, Frank Winkler, Wolfgang Wick & Simon Nagel
Beschreibung
Zusammenfassung:Purpose  Patients with glioblastoma (GBM) or brain metastases (MET) and atrial fibrillation (AF) might be at an increased risk of intracranial hemorrhage (ICH) due to anticoagulation (AC). Our aim was to assess this risk. - Methods  Our institution’s database (from 2005 to 2017) was screened for patients with GBM or MET and AF with an indication for AC according to their ­CHA2DS2VASc stroke risk score (≥ 2). Required follow-up was at least 3 months. AC was either performed with heparins, phenprocoumon or non-Vitamin K antagonist oral anticoagulants. Applying the propensity score approach, patient cohorts (matched according to primary tumor, age, sex) were generated (GBM [or MET] with AF ± AC, GBM [or MET] without AF/AC, no GBM [or MET] but AF on AC). ICH was defined as clinical deterioration caused by new blood on imaging. A log rank test was performed to compare the risk for ICH between the three groups. - Results  In total, 104 patients were identified of which 49 with GBM (37% on AC) and 37 with MET (46% on AC) were successfully matched. Median follow up was 8.6 and 7.2 months, respectively. ICH occurred in 10.2% of GBM + AF and 12.2% GBM-AF, whereas 8% of patients with AF on AC suffered ICH (p = 0.076). 13.5% of patients with MET + AF had ICHs, in the controls it was 16% for MET-AF and 8% for AF on AC (p = 0.11). - Conclusion  AC did not seem to influence the incidence of ICH in patients with glioblastoma or brain metastases within follow up of just under 9 months.
Beschreibung:Gesehen am 23.10.2023
Beschreibung:Online Resource
ISSN:1573-7373
DOI:10.1007/s11060-021-03716-8

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