Abstract Details

Title Efficacy and Safety of Tranexamic Acid in Spontaneous Intracerebral Hemorrhage: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P1 - Poster Session 1 (11:45 AM-12:45 PM)

Poster/Presentation
Number 13-001

Objective

This study aims to assess the efficacy and safety of Tranexamic acid (TXA) in acute spontaneous intracerebral hemorrhage (ICH).

Background Tranexamic acid (TXA), an antifibrinolytic agent, may help limit hematoma expansion in intracerebral hemorrhage (ICH), particularly in patients on non-vitamin K antagonist oral anticoagulants (NOACs). However, evidence-based treatment for NOAC-ICH is lacking, and the effectiveness of TXA in preventing hematoma growth remains uncertain. This study aims to assess the efficacy and safety of intravenous TXA in reducing hematoma expansion compared to placebo.

Design/Methods PubMed, Scopus, and Cochrane Library were searched till September 2024. Data were pooled as Risk ratios (RR) and Mean difference (MD) with a 95% Confidence Interval (CI) for the dichotomous and continuous outcomes respectively using the random effects model in the Review Manager version 5.4.1. The primary outcome was hematoma expansion, while secondary outcomes included 3-month poor functional outcomes (PFO), mortality, and major thromboembolic events (MTE). The quality of the included studies was evaluated using the Cochrane RoB 2.0 tool and publication bias through funnel plots. Sensitivity analysis was conducted for heterogeneity.

Results

A total of seven randomized controlled trials involving 2,914 participants were included in the analysis. TXA showed a non-significant decrease in HE compared to the placebo, with an RR of 0.89 (95% CI: [0.79,1.01]; p = 0.06; I² = 0%). The two groups were comparable in terms of PFO (RR=1.00; 95% CI:[0.93,1.07]; p = 0.95; I² = 0%), 3-month mortality (RR=1.03; 95% CI:[0.90,1.19]; p = 0.67; I² = 0%), and MTE (RR=1.16; 95% CI:[0.79,1.70]; p = 0.45; I² = 0%).

Conclusions

TXA showed a non-significant reduction in HE. Additionally, there were no significant differences in poor functional outcomes, mortality, or major thromboembolic events between the TXA and placebo groups. Further research is needed to confirm its potential benefits.

Authors/Disclosures
Muhammad W. Ansari, MD (UTMB) PRESENTER	Dr. Ansari has nothing to disclose.
Hassan Waseem	Hassan Waseem has nothing to disclose.
Zain U. Abideen, MBBS	Dr. Abideen has nothing to disclose.
Muhammad Fawad Tahir, MBBS	Dr. Fawad Tahir has nothing to disclose.
Rowaid Ahmad, MBBS	Dr. Ahmad has nothing to disclose.
Sania Aimen, MBBS	Dr. Aimen has nothing to disclose.

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