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Baranich A.I.

Burdenko Neurosurgical Center;
Plekhanov Russian University of Economics

Sychev A.A.

Burdenko Neurosurgical Center

Savin I.A.

Burdenko Neurosurgical Center

Kudrina V.G.

Plekhanov Russian University of Economics;
Russian Medical Academy of Continuous Professional Education

Kozlov A.V.

Burdenko Neurosurgical Center;
Andijan State Medical Institute

Correction of the effect of vitamin K antagonists and antiplatelet agents in hemorrhagic stroke

Authors:

Baranich A.I., Sychev A.A., Savin I.A., Kudrina V.G., Kozlov A.V.

More about the authors

Journal: Burdenko's Journal of Neurosurgery. 2024;88(6): 103‑109

DOI: 10.17116/neiro202488061103

Read: 2196 times

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Table of contents

CORRECTION OF THE EFFECT OF VITAMIN K ANTAGONISTS AND ANTIPLATELET AGENTS IN HEMORRHAGIC STROKE
CORRECTION OF THE EFFECT OF VITAMIN K ANTAGONISTS AND ANTIPLATELET AGENTS IN HEMORRHAGIC STROKE

To cite this article:

Baranich AI, Sychev AA, Savin IA, Kudrina VG, Kozlov AV. Correction of the effect of vitamin K antagonists and antiplatelet agents in hemorrhagic stroke. Burdenko's Journal of Neurosurgery. 2024;88(6):103‑109. (In Russ., In Engl.)
https://doi.org/10.17116/neiro202488061103

Подписка 2025 Журнал «Вопросы нейрохирургии» имени Н.Н. Бурденко (Burdenko's Journal of Neurosurgery)
МСФ на ЯМ
Использование инфографики авторами научных работ
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Abstract:

BACKGROUND

Hemorrhagic stroke (HS) is associated with high risk of mortality or disability. To date, up to 25% of HSs are associated with anticoagulants and antiplatelet agents. Early hemostatic therapy and correction of effect of antithrombotic drugs in patients with HS significantly reduce the risk of adverse outcomes. The latest international guidelines on this issue were presented almost 10 years ago.

MATERIAL AND METHODS

In accordance with the PRISMA recommendations, we reviewed the PubMed, eLibrary and UpToDate databases and identified 137 articles. Of these, 52 were enrolled as the most relevant.

RESULTS AND DISCUSSION

Regarding correction of the effect of indirect anticoagulants, various researchers discuss the possibility of either individual dosing or injection of a fixed dose of 4- or 3-factor prothrombin complex (1000—2000 IU regardless of body weight and international normalized ratio). To correct the effect of antiplatelet agents, platelet transfusion and desmopressin are proposed. There is currently no evidence of safety and effectiveness of both methods in patients with HS.

CONCLUSION

The optimal drug for correction of the effect of indirect anticoagulants is 4- or 3-factor prothrombin complex. In the last case, it is necessary to administer factor VIIa or fresh frozen plasma, as well as parenteral form of phytomenadione (vitamin K1) in all cases. The issue of correction of the effects of antiplatelet agents remains open. Regular analysis of available data with updating the guidelines for correction of the effect of anticoagulants and antiplatelet agents in HS is necessary.

Keywords:

hemorrhagic stroke
anticoagulants
antiplatelet agents
hemostatic therapy
antithrombotic drugs

Authors:

Baranich A.I.

Burdenko Neurosurgical Center;
Plekhanov Russian University of Economics

Sychev A.A.

Burdenko Neurosurgical Center

Savin I.A.

Burdenko Neurosurgical Center

Kudrina V.G.

Plekhanov Russian University of Economics;
Russian Medical Academy of Continuous Professional Education

Kozlov A.V.

Burdenko Neurosurgical Center;
Andijan State Medical Institute

Received:

18.07.2024

Accepted:

20.09.2024

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