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Reversing Intracerebral Hemorrhage in Patients Taking VKA

An international analysis comparing FFP and PCC

Publish date:: May 26, 2015

A combination of fresh frozen plasma (FFP) and prothrombin complex concentrate (PCC) may be the best treatment strategy for reversing intracerebral hemorrhage in patients on vitamin K antagonists (VKA-ICH), according to an international study of 10,282 patients with intracerebral hemorrhage from 16 stroke registries.

Investigators included 1,547 patients with VKA-ICH who were treated with FFP, PCC, or both and found:

	FFP	PCC	Both	Neither
n	377	585	131	454
Crude case Fatality	45.6%	37.3%	27.8%	61.7%
Adjusted HR	1.34	1.45	reference	2.54%

In addition, 4-factor PCC was associated with a 1.44 higher case fatality rate than 3-factor PCC.

Citation: Parry-Jones AR, Di Napoli M, Goldstein JN, et al. Reversal strategies for vitamin K antagonists in acute intracerebral hemorrhage. Ann Neurol. 2015. doi: 10.1002/ana.24416.

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