Tranexamic acid in intracerebral hemorrhage: a meta-analysis

Abstract

Background: Tranexamic acid(TA) is an antifibrinolytic agent, which has shown an effect on reducing blood loss in many diseases. Tranexamic acid might be beneficial for intracerebral hemorrhage(ICH). However, whether TA can treatment of intracerebral hemorrhage is still controversial.

Objective

Evidence-based medicine was used to evaluate the efficacy and safety of tranexamic acid in patients with intracerebral hemorrhage.

Methods

Pubmed (MEDLINE), Embase, and Cochrane Library were searched from January 2001 to October 2020 for randomized controlled trials (RCTs), cohort studies, and retrospective case series .The Jadad scale and RevMan software version 5.3 were used for literature quality assessment and meta-analysis.

Results

In total, 4 randomized controlled trials and 1 retrospective case series with 2808 participants were included in the meta-analysis. Compared with control intervention in intracerebral hemorrhage, tranexamic acid could significantly reduce growth of hemorrhagic mass (odds ratio (OR) =0.81; 95% confidence interval(CI)=0.68 to 0.99; p = 0.04) and Modified Rankin Scale score (MRS) at 90 days at 0–3 (OR = 1.20; 95% CI = 1.00 to 1.43; p = 0.05), mortality by day 90 (OR= 1.03; 95% CI= 0.85–1.25; p = 0.77) and major thromboembolic events (OR= 1.14; 95% CI= 0.73–1.77; p = 0.58).

Conclusions

Treatment with tranexamic acid could reduce hematoma expansion in intracerebral hemorrhage, and the treatment was safe with no increase in thromboembolic complications. But showed no notable impact on good functional outcomes and mortality.

Keywords:

• Tranexamic acid
• intracerebral hemorrhage
• treatment
• meta-analysis

Acknowledgments

We would like to thank American Journal Experts for assistance with revising the grammar, syntax, and phrasing of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Table 1. Characteristics of included studies.

Additional information

Funding

This study was funded by the Science & Technology Department of Sichuan Province [grant number 2018SZ0166] in the analysis, and LL review articles. Health Department of Sichuan Province.