Back to Search
Start Over
Estimating the Quantitative Demand of NOAC Antidote Doses on Stroke Units.
- Source :
-
Cerebrovascular diseases (Basel, Switzerland) [Cerebrovasc Dis] 2016; Vol. 42 (5-6), pp. 415-420. Date of Electronic Publication: 2016 Jul 21. - Publication Year :
- 2016
-
Abstract
- Background: The first specific antidote for non-vitamin K antagonist oral anticoagulants (NOAC) has recently been approved. NOAC antidotes will allow specific treatment for 2 hitherto problematic patient groups: patients with oral anticoagulant therapy (OAT)-associated intracerebral hemorrhage (ICH) and maybe also thrombolysis candidates presenting on oral anticoagulation (OAT). We aimed to estimate the frequency of these events and hence the quantitative demand of antidote doses on a stroke unit.<br />Methods: We extracted data of patients with acute ischemic stroke and ICH (<24 h after symptom onset) in the years 2012-2015 from a state-wide prospective stroke inpatient registry. We selected 8 stroke units and determined the mode of OAT upon admission in 2012-2013. In 2015, the mode of OAT became a mandatory item of the inpatient registry. From the number of anticoagulated patients and the NOAC share, we estimated the current and future demand for NOAC antidote doses on stroke units.<br />Results: Eighteen percent of ICH patients within 6 h of symptom onset or an unknown symptom onset were on OAT. Given a NOAC share at admission of 40%, about 7% of all ICH patients may qualify for NOAC reversal therapy. Thirteen percent of ischemic stroke patients admitted within 4 h presented on anticoagulation. Given the availability of an appropriate antidote, a NOAC share of 50% could lead to a 6.1% increase in thrombolysis rate.<br />Conclusions: Stroke units serving populations with a comparable demographic structure should prepare to treat up to 1% of all acute ischemic stroke patients and 7% of all acute ICH patients with NOAC antidotes. These numbers may increase with the mounting prevalence of atrial fibrillation and an increasing use of NOAC.<br /> (© 2016 S. Karger AG, Basel.)
- Subjects :
- Administration, Oral
Aged
Aged, 80 and over
Anticoagulants administration & dosage
Cerebral Hemorrhage chemically induced
Cerebral Hemorrhage diagnosis
Female
Forecasting
Germany
Humans
Male
Middle Aged
Registries
Stroke diagnosis
Anticoagulants adverse effects
Antidotes supply & distribution
Cerebral Hemorrhage drug therapy
Health Services Needs and Demand trends
Hospital Units trends
Needs Assessment trends
Stroke drug therapy
Thrombolytic Therapy adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1421-9786
- Volume :
- 42
- Issue :
- 5-6
- Database :
- MEDLINE
- Journal :
- Cerebrovascular diseases (Basel, Switzerland)
- Publication Type :
- Academic Journal
- Accession number :
- 27438461
- Full Text :
- https://doi.org/10.1159/000447952