Outcomes of Argatroban Treatment in Patients With Atherothrombotic Stroke
- 1 February 2016
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 47 (2), 471-476
- https://doi.org/10.1161/strokeaha.115.011250
Abstract
Background and Purpose—: Argatroban, a selective thrombin inhibitor, is recommended for the use in patients with atherothrombotic stroke by the Japanese Guidelines for the Management of Patients with Acute Ischemic Stroke. We performed a nationwide Japanese study to investigate whether argatroban improved early stroke outcomes in patients with acute atherothrombotic stroke. Methods—: This retrospective observational study, using the Diagnosis Procedure Combination database in Japan, included patients who were hospitalized from July 1, 2010, to March 31, 2012, with a diagnosis of atherothrombotic stroke within 1 day of stroke onset. Patients were divided into 2 groups: those receiving argatroban on admission (argatroban group), and those who did not receive argatroban during hospitalization (control group). To balance the baseline characteristics and concomitant treatments during hospitalization between the 2 groups, one-to-one propensity-score matching analyses were performed. The main outcomes were the modified Rankin Scale score at discharge and the occurrence of hemorrhagic complications during hospitalization. An ordinal logistic regression analysis evaluated the association between argatroban use and modified Rankin Scale at discharge. Results—: After propensity-score matching, 2289 pairs of patients were analyzed. There were no significant differences in modified Rankin Scale at discharge between the argatroban and the control groups (adjusted odds ratio, 1.01; 95% confidence interval, 0.88–1.16). The occurrence of hemorrhagic complications did not differ significantly between the argatroban and the control groups (3.5% versus 3.8%; P =0.58). Conclusions—: The present study suggested that argatroban was safe, but had no added benefit in early outcomes after acute atherothrombotic stroke.Keywords
This publication has 12 references indexed in Scilit:
- Direct Thrombin Inhibitor Argatroban Reduces Stroke Damage in 2 Different ModelsStroke, 2014
- Comparison of the European and Japanese Guidelines for the Management of Ischemic StrokeCerebrovascular Diseases, 2013
- The eye response test alone is sufficient to predict stroke outcome—reintroduction of Japan Coma Scale: a cohort studyBMJ Open, 2013
- Guidelines for the Early Management of Patients With Acute Ischemic StrokeStroke, 2013
- Thrombin Activity Associated with Neuronal Damage during Acute Focal IschemiaJournal of Neuroscience, 2012
- The Argatroban and Tissue-Type Plasminogen Activator Stroke StudyStroke, 2012
- Diagnosis Procedure Combination as an Infrastructure for the Clinical StudyAsian Pacific Journal of Disease Management, 2011
- Argatroban Anticoagulation in Patients With Acute Ischemic Stroke (ARGIS-1)Stroke, 2004
- Effect of the Thrombin Inhibitor Argatroban in Acute Cerebral ThrombosisSeminars in Thrombosis and Hemostasis, 1997
- Thrombin inhibition in the acute phase of ischaemic stroke using argatrobanBlood Coagulation & Fibrinolysis, 1995