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The use of warfarin has increased since 1990, in part because of clinical trials showing that it reduces the incidence of stroke in patients with atrial fibrillation. In this study, researchers examined whether this trend has been associated with an increase in intracerebral hemorrhage (ICH), perhaps the most feared bleeding complication of warfarin.
In a five-county area around Cincinnati, the overall incidence of ICH increased only modestly between 1988 and 1999. However, the annual incidence of ICH associated with anticoagulation (nearly always warfarin) increased markedly during this interval, from about 1 case per 100,000 persons in 1988 to 4 cases per 100,000 in 1999. Correspondingly, the proportion of all ICH cases associated with ant…