{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:08:53Z","timestamp":1787242133218,"version":"build-2736575974"},"reference-count":15,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T00:00:00Z","timestamp":1731283200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can. J. Neurol. Sci."],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec id=\"S0317167124003251_as1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Growing evidence suggests that direct oral anticoagulants (DOACs) may be suitable for cerebral venous thrombosis (CVT). The optimal strategy regarding lead-in parenteral anticoagulation (PA) prior to DOAC is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0317167124003251_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this post hoc analysis of the retrospective ACTION-CVT study, we compared patients treated with DOACs as part of routine care: those given \u201cvery early\u201d DOAC (no PA), \u201cearly\u201d (&lt;5 days PA) and \u201cdelayed\u201d (5\u201321 days PA). We compared baseline characteristics and outcomes between the very early\/early and delayed groups. The primary outcome was a composite of day-30 CVT recurrence\/extension, new peripheral venous thromboembolism, cerebral edema and intracranial hemorrhage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0317167124003251_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of 231 patients, 11.7% had very early DOAC, 64.5% early (median [IQR] 2 [1\u20132] days) and 23.8% delayed (5 [5\u20136] days). More patients had severe clinical\/radiological presentations in the delayed group; more patients had isolated headaches in the very early\/early group. Outcomes were better in the very early\/early groups (90-day modified Rankin Scale of 0\u20132; 94.3% vs. 83.9%). Primary outcome events were rare and did not differ significantly between groups (2.4% vs. 2.1% delayed; adjusted HR 1.49 [95%CI 0.17\u201313.11]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0317167124003251_as4\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In this cohort of patients receiving DOAC for CVT as part of routine care, &gt;75% had &lt;5 days of PA. Those with very early\/early initiation of DOAC had less severe clinical presentations. Low event rates and baseline differences between groups preclude conclusions about safety or effectiveness. Further prospective data will inform care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/cjn.2024.325","type":"journal-article","created":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T04:53:29Z","timestamp":1731300809000},"page":"1-6","source":"Crossref","is-referenced-by-count":3,"title":["Lead-In Parenteral Anticoagulation Prior to Direct Oral Anticoagulation for Cerebral Venous Thrombosis"],"prefix":"10.1017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1176-0633","authenticated-orcid":false,"given":"Thalia S.","family":"Field","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liqi","family":"Shu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0243-799X","authenticated-orcid":false,"given":"Diana J.","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piers","family":"Klein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James E.","family":"Siegler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Cushman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3064-0864","authenticated-orcid":false,"given":"Lily W.","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanh N.","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shadi","family":"Yaghi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2024,11,11]]},"reference":[{"key":"S0317167124003251_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.rpth.2023.100143"},{"key":"S0317167124003251_ref5","first-page":"1","article-title":"Canadian Stroke Best Practice Recommendations, 7(th) Edition: Cerebral Venous Thrombosis, 2024","author":"Field","year":"2024","journal-title":"Can J Neurol Sci England"},{"key":"S0317167124003251_ref9","first-page":"404","article-title":"Outcome prediction in cerebral venous thrombosis: the IN-REvASC score","volume":"24","author":"Klein","year":"2022","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"S0317167124003251_ref4","first-page":"e77","volume-title":"Diagnosis and management of cerebral venous thrombosis: a scientific statement from the American Heart Association. Stroke","volume":"55","author":"Saposnik","year":"2024"},{"key":"S0317167124003251_ref10","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000117571.76197.26"},{"key":"S0317167124003251_ref11","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13381"},{"key":"S0317167124003251_ref2","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020003244"},{"key":"S0317167124003251_ref15","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2023.1251581"},{"key":"S0317167124003251_ref13","first-page":"256","article-title":"Global impact of the COVID-19 pandemic on cerebral venous thrombosis and mortality","volume":"24","author":"Nguyen","year":"2022","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"S0317167124003251_ref3","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.123.044113"},{"key":"S0317167124003251_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2023.11.028"},{"key":"S0317167124003251_ref12","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.122.039390"},{"key":"S0317167124003251_ref1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2019.2764"},{"key":"S0317167124003251_ref7","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000201122"},{"key":"S0317167124003251_ref6","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.121.037541"}],"container-title":["Canadian Journal of Neurological Sciences \/ Journal Canadien des Sciences Neurologiques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0317167124003251","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T23:29:37Z","timestamp":1734650977000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0317167124003251\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,11]]},"references-count":15,"alternative-id":["S0317167124003251"],"URL":"https:\/\/doi.org\/10.1017\/cjn.2024.325","relation":{},"ISSN":["0317-1671","2057-0155"],"issn-type":[{"value":"0317-1671","type":"print"},{"value":"2057-0155","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,11]]}}}