Should Patients with AF and History of Intracranial Hemorrhage Be Anticoagulated?

Darned if you do, darned if you don't.

Oral anticoagulants reduce the risk for ischemic stroke in patients with atrial fibrillation (AF). However, if these patients suffer an intracranial hemorrhage (ICH), whether to restart anticoagulation therapy becomes a therapeutic uncertainty. The current investigators used a Taiwanese national database to identify 12,917 patients with an ICH history and new AF and to analyze outcomes according to whether they received no treatment, antiplatelet therapy, or warfarin, as chosen by the treating physician.

During a follow-up of 3.3 years, there were 1599 ICH events and 1675 ischemic-stroke events. A history of ICH was an independent risk factor for further ICH after adjustment for age, sex, CHA₂DS₂-VASc score, and other comorbidities (hazard r…

Reviewing Author

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Should Patients with AF and History of Intracranial Hemorrhage Be Anticoagulated?

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Reviewing Author