Tsivgoulis G.Wilson D.Katsanos A.H.Sargento-Freitas J.Marques-Matos C.Azevedo E.Adachi T.von der Brelie C.Aizawa Y.Abe H.Tomita H.Okumura K.Hagii J.Seiffge D.J.Lioutas V.-A.Traenka C.Varelas P.Basir G.Krogias C.Purrucker J.C.Sharma V.K.Rizos T.Mikulik R.Sobowale O.A.Barlinn K.Sallinen H.Goyal N.SHIN-JOE YEHKarapanayiotides T.Wu T.Y.Vadikolias K.Ferrigno M.Hadjigeorgiou G.Houben R.Giannopoulos S.Schreuder F.H.B.M.Chang J.J.Perry L.A.Mehdorn M.Marto J.-P.Pinho J.Tanaka J.Boulanger M.Salman R.A.-S.J?ger H.R.Shakeshaft C.Yakushiji Y.Choi P.M.C.Staals J.Cordonnier C.JIANN-SHING JENGVeltkamp R.Dowlatshahi D.Engelter S.T.Parry-Jones A.R.Meretoja A.Mitsias P.D.Alexandrov A.V.Ambler G.Werring D.J.2020-03-052020-03-0520180364-5134https://www.scopus.com/inward/record.uri?eid=2-s2.0-85055512078&doi=10.1002%2fana.25342&partnerID=40&md5=41b3cd2226ca17234c9d9e5fdf8cd058https://scholars.lib.ntu.edu.tw/handle/123456789/470120Objective: Whether intracerebral hemorrhage (ICH) associated with non–vitamin K antagonist oral anticoagulants (NOAC-ICH) has a better outcome compared to ICH associated with vitamin K antagonists (VKA-ICH) is uncertain. Methods: We performed a systematic review and individual patient data meta-analysis of cohort studies comparing clinical and radiological outcomes between NOAC-ICH and VKA-ICH patients. The primary outcome measure was 30-day all-cause mortality. All outcomes were assessed in multivariate regression analyses adjusted for age, sex, ICH location, and intraventricular hemorrhage extension. Results: We included 7 eligible studies comprising 219 NOAC-ICH and 831 VKA-ICH patients (mean age = 77 years, 52.5% females). The 30-day mortality was similar between NOAC-ICH and VKA-ICH (24.3% vs 26.5%; hazard ratio = 0.94, 95% confidence interval [CI] = 0.67–1.31). However, in multivariate analyses adjusting for potential confounders, NOAC-ICH was associated with lower admission National Institutes of Health Stroke Scale (NIHSS) score (linear regression coefficient = ?2.83, 95% CI = ?5.28 to ?0.38), lower likelihood of severe stroke (NIHSS > 10 points) on admission (odds ratio [OR] = 0.50, 95% CI = 0.30–0.84), and smaller baseline hematoma volume (linear regression coefficient = ?0.24, 95% CI = ?0.47 to ?0.16). The two groups did not differ in the likelihood of baseline hematoma volume < 30cm3 (OR = 1.14, 95% CI = 0.81–1.62), hematoma expansion (OR = 0.97, 95% CI = 0.63–1.48), in-hospital mortality (OR = 0.73, 95% CI = 0.49–1.11), functional status at discharge (common OR = 0.78, 95% CI = 0.57–1.07), or functional status at 3 months (common OR = 1.03, 95% CI = 0.75–1.43). Interpretation: Although functional outcome at discharge, 1 month, or 3 months was comparable after NOAC-ICH and VKA-ICH, patients with NOAC-ICH had smaller baseline hematoma volumes and less severe acute stroke syndromes. Ann Neurol 2018;84:702–712. ? 2018 American Neurological Association[SDGs]SDG3anticoagulant agent; apixaban; dabigatran; fresh frozen plasma; idarucizumab; rivaroxaban; vitamin K group; anticoagulant agent; vitamin K group; aged; Article; brain hemorrhage; cerebrovascular accident; clinical outcome; drug use; female; follow up; functional status; Glasgow coma scale; hematoma; hospital mortality; human; international normalized ratio; major clinical study; male; mortality; National Institutes of Health Stroke Scale; neuroimaging; priority journal; adult; antagonists and inhibitors; brain hemorrhage; chemically induced; meta analysis; middle aged; neuroimaging; oral drug administration; pathology; very elderly; Administration, Oral; Adult; Aged; Aged, 80 and over; Anticoagulants; Cerebral Hemorrhage; Female; Humans; Male; Middle Aged; Neuroimaging; Vitamin Kjournal article10.1002/ana.25342302559702-s2.0-85055512078