Non-contrast CT Markers of Hematoma Expansion and Andexanet Response in Factor Xa Inhibitor-Associated Intracerebral Hemorrhage: An Analysis from ANNEXa-I Trial

IF 7.5 1区医学 Q1 CLINICAL NEUROLOGY

Annals of Neurology Pub Date : 2026-10-22 Epub Date: 2026-09-08 DOI:10.1002/ana.78347

Koji Tanaka MD, PhD, Umberto Pensato MD, Mohamed Alshamrani MD, Aristeidis H. Katsanos MD, PhD, Pargol Balali MD, MSc, Sucharita Ray MD, Scott E. Kasner MD, Jan Beyer-Westendorf MD, Danilo Toni MD, David J. Seiffge MD, Carlos Molina MD, David Tanne MD, Anna Członkowska MD, PhD, Arne G. Lindgren MD, PhD, Daniel Bereczki MD, Else C. Sandset MD, Georgios Tsivgoulis MD, PhD, MSc, Hanne Christensen MD, Jonathan M. Coutinho MD, PhD, Peter Verhamme MD, Pierre Amarenco MD, Robin Lemmens MD, PhD, Roland Veltkamp MD, Saskia Middeldorp MD, Thompson Robinson MD, Truman J. Milling MD, Wilfried Lang MD, Vitor Tedium-Cruz MD, PhD, Mark Crowther MD, Lizhen Xu PhD, Mikael Knutsson PhD, Per Ladenvall MD, PhD, John W. Eikelboom MD, Mukul Sharma MD, Ashkan Shoamanesh MD, Andrew M. Demchuk MD

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Abstract

In this post hoc analysis of the ANNEXa-I trial (n = 434), we evaluated non-contrast computed tomography (NCCT) markers of hematoma expansion (HE) in factor Xa inhibitor (FXai) –associated intracerebral hemorrhage (ICH). At least one NCCT marker was present in 72.1%, and HE (≥12.5 mL or ≥ 35% increase in hematoma volume) occurred in 31.8%. Heterogeneous density, hypodensity, and the black hole sign were independently associated with HE. The effect of andexanet on HE was generally consistent across NCCT marker subgroups. These findings support the utility of NCCT markers for identifying patients at high risk of HE in FXai-associated ICH. ANN NEUROL 2026;100:979–983

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Xa因子抑制剂相关脑出血血肿扩张和安德沙奈反应的非对比CT标记物：来自附件i试验的分析。

在这项对annexa - 1试验（n = 434）的事后分析中，我们评估了Xa因子抑制剂（FXai）相关脑出血（ICH）中血肿扩张（HE）的非对比计算机断层扫描（NCCT）标志物。72.1%的患者至少存在一种NCCT标记物，31.8%的患者出现HE（≥12.5 mL或血肿体积增加≥35%）。非均匀密度、低密度和黑洞符号与HE独立相关。anddexanet对HE的影响在NCCT标志物亚组中基本一致。这些发现支持NCCT标记物用于识别fxai相关性脑出血中HE高风险患者的效用。Ann neurol 2026。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Neurology 医学-临床神经学

CiteScore

18.00

自引率

1.80%

发文量

270

审稿时长

3-8 weeks

期刊介绍： Annals of Neurology publishes original articles with potential for high impact in understanding the pathogenesis, clinical and laboratory features, diagnosis, treatment, outcomes and science underlying diseases of the human nervous system. Articles should ideally be of broad interest to the academic neurological community rather than solely to subspecialists in a particular field. Studies involving experimental model system, including those in cell and organ cultures and animals, of direct translational relevance to the understanding of neurological disease are also encouraged.