Antifibrinolytic treatment in subarachnoid hemorrhage

M. Vermeulen, K. W. Lindsay, G. D. Murray, F. Cheah, A. Hijdra, Jan Paul Muizelaar, M. Schannong, G. M. Teasdale, H. van Crevel, J. van Gijn

Research output: Contribution to journalArticle

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Abstract

We enrolled 479 patients with subarachnoid hemorrhage in a multicenter, randomized, double-blind placebo-controlled trial to determine whether treatment with the antifibrinolytic agent tranexamic acid improves outcome by preventing rebleeding. All three months there was no statistical difference between the outcomes in the tranexamic acid group and the control group. Of the 173 patients who died, 84 had received tranexamic acid and 89 placebo (95 per cent confidence interval for the difference in mortality rate, - 6 to 11 per cent). Similarly, when analysis was restricted to patients with an angiographically demonstrated aneurysm, there was no significant difference between the groups. This absence of effect was not due to a lack of antifibrinolytic action, since the rate of rebleeding was reduced from 24 per cent in the control group to 9 per cent in the tranexamic acid-treated group (chi-square = 18.07, P < 0.001), but resulted from a concurrent increase in the incidence of ischemic complications (15 per cent in the control group and 24 per cent in the tranexamic acid group; chi-square = 8.07, P < 0.01). We conclude that until some method can be found to minimize ischemic complications, tranexamic acid is of no benefit in patients with subarachnoid hemorrhage.

Original languageEnglish (US)
Pages (from-to)432-437
Number of pages6
JournalNew England Journal of Medicine
Volume311
Issue number7
StatePublished - 1984
Externally publishedYes

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Tranexamic Acid
Antifibrinolytic Agents
Subarachnoid Hemorrhage
Control Groups
Therapeutics
Placebos
Aneurysm
Confidence Intervals
Mortality
Incidence

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Vermeulen, M., Lindsay, K. W., Murray, G. D., Cheah, F., Hijdra, A., Muizelaar, J. P., ... van Gijn, J. (1984). Antifibrinolytic treatment in subarachnoid hemorrhage. New England Journal of Medicine, 311(7), 432-437.

Antifibrinolytic treatment in subarachnoid hemorrhage. / Vermeulen, M.; Lindsay, K. W.; Murray, G. D.; Cheah, F.; Hijdra, A.; Muizelaar, Jan Paul; Schannong, M.; Teasdale, G. M.; van Crevel, H.; van Gijn, J.

In: New England Journal of Medicine, Vol. 311, No. 7, 1984, p. 432-437.

Research output: Contribution to journalArticle

Vermeulen, M, Lindsay, KW, Murray, GD, Cheah, F, Hijdra, A, Muizelaar, JP, Schannong, M, Teasdale, GM, van Crevel, H & van Gijn, J 1984, 'Antifibrinolytic treatment in subarachnoid hemorrhage', New England Journal of Medicine, vol. 311, no. 7, pp. 432-437.
Vermeulen M, Lindsay KW, Murray GD, Cheah F, Hijdra A, Muizelaar JP et al. Antifibrinolytic treatment in subarachnoid hemorrhage. New England Journal of Medicine. 1984;311(7):432-437.
Vermeulen, M. ; Lindsay, K. W. ; Murray, G. D. ; Cheah, F. ; Hijdra, A. ; Muizelaar, Jan Paul ; Schannong, M. ; Teasdale, G. M. ; van Crevel, H. ; van Gijn, J. / Antifibrinolytic treatment in subarachnoid hemorrhage. In: New England Journal of Medicine. 1984 ; Vol. 311, No. 7. pp. 432-437.
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