TRANEXAMIC ACID FOR ACUTE INTRACEREBRAL HEMORRHAGE GROWTH BASED ON IMAGING ASSESSMENT (TRAIGE)

Session Type
Plenary Session
Date
Wed, 01.09.2021
Session Time
10:30 - 12:30
Room
Hall A
Lecture Time
10:35 - 10:45
Presenter
  • Jingyi Liu (China)

Abstract

Group Name

The TRAIGE Collaborators

Beijing Tiantan Hospital
Liping Liu (PI), Zhonghua Yang, Miao Wen, Ximing Nie, Ying Tan, Yaozhi Chen, Dacheng Liu, Lina Zheng, Jingyi Liu, Jiahui Zhao

Tangshan People’s Hospital
Yan Wang (PI), Mingyang Sun, Wenjian Shi

Tangshan Gongren Hospital
Yibin Cao (PI), Zilong Rao, Yakun Wu, Fengqun Mu, Fengjie Kan, Haiying Wang, Xin Li, Nan Shi, Min Yuan, Yuling Yang, Lingyun Wu, Jingjing Li, Peng Sun, Hong Zhang, Jing Liu, Yueming Tian, Sujie Wang, Qian Li, Lili Chen, Pei Li, Jinghua Liu, Lijuan Liu

Beijing Luhe Hospital
Haomeng Zhu (PI), Huishan Du, Yan’na Tong, Nan Zhang, Fengli Che

Beijing Pinggu Hospital
Yunpeng Zhang (PI), Changbao Li, Yan Wang, Yuming Li, Jincheng Zhang, Jinju Yang

Liangxiang Hospital of Beijing Fangshan District
Lijin Yi (PI), Qingwei Meng, Wenqin Han, Lan Ma, Xinzhang Mu, Jing Yin, Ningning Qin

Kailuan General Hospital, Hebei
Ying Ma (PI), Nannan Zhang, Ya Ou, Lifu Zhou, Yujie Sun, Meng Zhao, Lili Zhang, Yesong Liu, Xiaodong Yuan

Beijing Huairou Hospital of University of Chinese Academy of Sciences
Fuying Yu (PI), Lijun Huang, Lixin Song, Jian Wang

Beijing Daxing District People’s Hospital
Fuming Shi (PI), Liping Dong

Beijing Haidian Hospital
Fengchun Yu (PI), Yongzhen Liu, Xiaomei Tang, Wei Liu, Ke Jia, Zhenghong Zhou, Qunyan Li, Hao Feng, Lei Liu, Fenghui Sun

Background And Aims

Studies show tranexamic acid can reduce the risk of death and early neurological deterioration after intracranial hemorrhage. We aimed to assess whether tranexamic acid reduces hematoma expansion and improves outcome in intracerebral hemorrhage patients susceptible to hemorrhage expansion.

Methods

We did a prospective, double-blind, randomized, placebo-controlled trial at 10 stroke centers in China. Acute supratentorial intracerebral hemorrhage patients were eligible if they had indication of hemorrhage expansion on admission imaging (e.g., spot sign, black hole sign, or blend sign), and were treatable within 8 hours of symptom onset. Patients were randomly assigned (1:1) to receive either tranexamic acid or a matching placebo. The primary outcome was intracerebral hematoma growth (>33% relative or >6 mL absolute) at 24 h. Clinical outcomes were assessed at 90 days.

Results

Of the 171 included patients, 124 (72.5%) were male, and the mean age was 55.9±11.6 years. 89 patients received tranexamic acid and 82 received placebo.36 (40.4%) patients in the tranexamic acid group and 34 (41.5%) patients in the placebo group had intracranial hemorrhage growth (odds ratio [OR] 0.96 [95% CI 0.52-1.77], p=0.89). Less proportion of death were observed in tranexamic acid treatment group than placebo group (8.1% vs 10.0%), but there were no significant differences in secondary outcomes including absolute intracranial hemorrhage growth, death, and dependency.

Conclusions

Among patients susceptible to hemorrhage expansion treated within 8 hours of stroke onset, tranexamic acid did not significantly prevent intracerebral hemorrhage growth. We found it was safe and caused less 90-day death.

Trial Registration Number

NCT02625948

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