1242. Timing of restarting antiplatelet therapy following primary diagnosis of intracerebral hemorrhage does not affect thirty-day adverse events

Authors: Ryan Chiu; Brett Geever, BS; Clayton Rosinski, BS; Saavan Patel, BS; Ashley Selner, PhD; Anisse Chaker, BA; Akash Patel, BS; Abhiraj Bhimani, BS; Matthew Wonais, BS; Gregory Arnone, MD; Prateek Kumar, BA; Ankit Mehta, MD (Chicago, IL)

Introduction:

Intracerebral hemorrhage (ICH) frequently occurs in the setting of antiplatelet therapy. Post-hemorrhagic care significantly affects mortality and morbidity. Previous studies on the use of antiplatelet therapy following ICH have reported conflicting results, showing either increased risk or no significant effect on re-bleeding, with limited analysis of other post-discharge outcomes. Additionally, there is a paucity of data regarding optimal timing to restart of antiplatelet therapy with regard to these outcomes.

This study compares 30-day outcomes of ICH patients based on whether antiplatelet therapy was restarted, as well as the timing of medication reinstatement. 

Methods:

A retrospective review of all adult patients on antiplatelet medication who presented to a tertiary academic medical center between 2012-2015 with a primary diagnosis of ICH was performed. The effect of restarting antiplatelet therapy after ICH, and the timing thereof, on patient outcomes and post-discharge adverse effects was assessed in comparison to withholding antiplatelet therapy. 

Results:

94 patients were studied, 25 (26.6%) who were restarted on their existing antiplatelet therapy and 69 (73.4%) who abstained. Patients restarted were similar to those who were not in their demographics and comorbidities. Comparative analyses demonstrated no significant association between restarting antiplatelet therapy, or timing thereof, and post-discharge outcomes. The mean time from antiplatelet discontinuation to restart was 20.08 ± 17.20 days.

Conclusion:

Restarting antiplatelet therapy does not significantly alter 30-day outcomes in adult ICH patients. Furthermore, the measured 30-day outcomes are not significantly altered by when antiplatelet therapy is resumed.