Anticoagulants for Patients with Atrial Fibrillation and Prior Brain Hemorrhage?

An admittedly inconclusive study points to some benefit of OACs in these patients.

Although oral anticoagulant (OAC) medications have proven effective for stroke prevention in patients with atrial fibrillation (AF), their role in patients with AF and a prior intracerebral hemorrhage (ICH) is uncertain.

These authors conducted the SoSTART trial at 67 hospitals in the United Kingdom. They recruited patients with AF and a prior ICH who survived at least 24 hours after the ICH and who also had a minimum CHA₂DS₂-VASc score of 2. Patients were randomized to “start” OAC medication or “avoid” OAC therapy; those in the avoid group could receive either antiplatelet therapy or no antithrombotic therapy. The primary endpoint was recurrent symptomatic ICH.

The 203 patients (median age 79; 63% men) recruited had a median CHA₂DS₂-VASc sco…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Anticoagulants for Patients with Atrial Fibrillation and Prior Brain Hemorrhage?

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Reviewing Author