Anticoagulation Status and Outcome in Cerebral Venous Thrombosis: A Single-Center Retrospective Study from South India
Background and Objectives: Early initiation and maintenance of anticoagulation appears to be the mainstay of treatment of cerebral venous thrombosis (CVT), but the evidence supporting the intensity and duration of anticoagulation is limited. Methods: We retrospectively collected data of patients adm...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-12-01
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| Series: | Annals of Indian Academy of Neurology |
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| Online Access: | https://journals.lww.com/10.4103/aian.aian_359_24 |
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| author | Deepak Menon Manisha Gupta Sangeeth Thuppanattumadam Ananthasubramanian Karthik Kulanthaivelu Pritam Raja Subasree Ramakrishnan Sangeetha Seshagiri Karnam Jitender Saini PR Srijithesh Girish B Kulkarni |
| author_facet | Deepak Menon Manisha Gupta Sangeeth Thuppanattumadam Ananthasubramanian Karthik Kulanthaivelu Pritam Raja Subasree Ramakrishnan Sangeetha Seshagiri Karnam Jitender Saini PR Srijithesh Girish B Kulkarni |
| author_sort | Deepak Menon |
| collection | DOAJ |
| description | Background and Objectives:
Early initiation and maintenance of anticoagulation appears to be the mainstay of treatment of cerebral venous thrombosis (CVT), but the evidence supporting the intensity and duration of anticoagulation is limited.
Methods:
We retrospectively collected data of patients admitted with CVT over a 5-year period, who had a minimum of 6 months of clinical follow-up and three or more prothrombin time international normalized ratio (INR) values spread over 6 months. Data collected included demographic, clinical, and radiologic parameters, anticoagulation status during the follow-up, complications, and clinical status at the last follow-up.
Results:
We identified 204 patients, and the mean age was 34.4 ± 11.1 years. The majority had a provoked etiology (194, 95.1%) for CVT. After initial anticoagulation with unfractionated heparin, all patients transitioned to acenocoumarol or warfarin and this was maintained for a mean duration of 16.02 ± 11.2 months. Time in therapeutic range of INR 2–3 was only 5.1 ± 11.8 percent days and time spent in an INR of 1–1.5 was 68.7 ± 31.8 percent days. The average INR over 6 months was 1.37 ± 0.33. Duration of follow-up was 18.9 ± 13.25 months, and a good outcome was noted in 183 (89.7%) patients. Complications were seen in 29 (14.2%) patients. Multivariate analysis showed only the CVT grading scale score to be an independent predictor of good outcome.
Conclusions:
Maintenance of an intensive level of anticoagulation may not be required in patients with CVT and may be particularly true when a transient and treatable risk factor is the provoking etiology. |
| format | Article |
| id | doaj-art-221134ec8905481c883c25ffc3e9dbed |
| institution | Kabale University |
| issn | 0972-2327 1998-3549 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Indian Academy of Neurology |
| spelling | doaj-art-221134ec8905481c883c25ffc3e9dbed2025-01-06T14:22:14ZengWolters Kluwer Medknow PublicationsAnnals of Indian Academy of Neurology0972-23271998-35492024-12-0127665766210.4103/aian.aian_359_24Anticoagulation Status and Outcome in Cerebral Venous Thrombosis: A Single-Center Retrospective Study from South IndiaDeepak MenonManisha GuptaSangeeth Thuppanattumadam AnanthasubramanianKarthik KulanthaiveluPritam RajaSubasree RamakrishnanSangeetha Seshagiri KarnamJitender SainiPR SrijitheshGirish B KulkarniBackground and Objectives: Early initiation and maintenance of anticoagulation appears to be the mainstay of treatment of cerebral venous thrombosis (CVT), but the evidence supporting the intensity and duration of anticoagulation is limited. Methods: We retrospectively collected data of patients admitted with CVT over a 5-year period, who had a minimum of 6 months of clinical follow-up and three or more prothrombin time international normalized ratio (INR) values spread over 6 months. Data collected included demographic, clinical, and radiologic parameters, anticoagulation status during the follow-up, complications, and clinical status at the last follow-up. Results: We identified 204 patients, and the mean age was 34.4 ± 11.1 years. The majority had a provoked etiology (194, 95.1%) for CVT. After initial anticoagulation with unfractionated heparin, all patients transitioned to acenocoumarol or warfarin and this was maintained for a mean duration of 16.02 ± 11.2 months. Time in therapeutic range of INR 2–3 was only 5.1 ± 11.8 percent days and time spent in an INR of 1–1.5 was 68.7 ± 31.8 percent days. The average INR over 6 months was 1.37 ± 0.33. Duration of follow-up was 18.9 ± 13.25 months, and a good outcome was noted in 183 (89.7%) patients. Complications were seen in 29 (14.2%) patients. Multivariate analysis showed only the CVT grading scale score to be an independent predictor of good outcome. Conclusions: Maintenance of an intensive level of anticoagulation may not be required in patients with CVT and may be particularly true when a transient and treatable risk factor is the provoking etiology.https://journals.lww.com/10.4103/aian.aian_359_24cerebral venous thrombosisanticoagulationinrtherapeutic rangeoutcome |
| spellingShingle | Deepak Menon Manisha Gupta Sangeeth Thuppanattumadam Ananthasubramanian Karthik Kulanthaivelu Pritam Raja Subasree Ramakrishnan Sangeetha Seshagiri Karnam Jitender Saini PR Srijithesh Girish B Kulkarni Anticoagulation Status and Outcome in Cerebral Venous Thrombosis: A Single-Center Retrospective Study from South India Annals of Indian Academy of Neurology cerebral venous thrombosis anticoagulation inr therapeutic range outcome |
| title | Anticoagulation Status and Outcome in Cerebral Venous Thrombosis: A Single-Center Retrospective Study from South India |
| title_full | Anticoagulation Status and Outcome in Cerebral Venous Thrombosis: A Single-Center Retrospective Study from South India |
| title_fullStr | Anticoagulation Status and Outcome in Cerebral Venous Thrombosis: A Single-Center Retrospective Study from South India |
| title_full_unstemmed | Anticoagulation Status and Outcome in Cerebral Venous Thrombosis: A Single-Center Retrospective Study from South India |
| title_short | Anticoagulation Status and Outcome in Cerebral Venous Thrombosis: A Single-Center Retrospective Study from South India |
| title_sort | anticoagulation status and outcome in cerebral venous thrombosis a single center retrospective study from south india |
| topic | cerebral venous thrombosis anticoagulation inr therapeutic range outcome |
| url | https://journals.lww.com/10.4103/aian.aian_359_24 |
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