Intracerebral Hemorrhage with the New Direct Oral Anticoagulants

In an observational study, intracerebral hemorrhages were less severe with the newer agents than with warfarin.

In randomized trials, incidence of intracerebral hemorrhage (ICH) was significantly lower with the direct oral anticoagulants (DOACs) than with warfarin (NEJM JW Gen Med Jan 1 2015 and Blood 2014; 124:1968). But when such bleeding does occur during treatment with DOACs or warfarin, are clinical outcomes similar? To address this question, U.K. researchers compared 52 patients who suffered ICHs while taking warfarin with 11 patients who suffered ICHs while taking DOACs (6 on rivaroxaban [Xarelto], 3 on dabigatran [Pradaxa], and 2 on apixaban [Eliquis]). Patients with major head trauma or known structural reasons for ICH were excluded. Mean international normalized ratio in warfarin patients was 2.5.

Median ICH volume was significantly larger w…

Reviewing Author

Allan S. Brett, MD

Disclosures

Nothing to disclose

Allan S. Brett, MD

Disclosures

Nothing to disclose

Intracerebral Hemorrhage with the New Direct Oral Anticoagulants

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Reviewing Author