Tradeoffs of Anticoagulation for Atrial Fibrillation After Nonfatal Intracranial Hemorrhage

In patients with atrial fibrillation (AF) who have an indication for oral anticoagulation and survive an intracranial hemorrhage (ICH), the risk-benefit tradeoffs of anticoagulation remain unknown. Individual randomized, controlled trials are mostly small, limiting the certainty of their conclusions. To strengthen the available evidence, investigators combined data from 4 randomized, controlled trials involving 650 participants (mean age, 78 years) followed for an average of 6 months to 2 years.

The primary outcome, net adverse clinical events — a composite of ischemic stroke or systemic thromboembolism, myocardial infarction, cardiovascular death, recurrent ICH, or extracranial major bleeding — occurred significantly less frequently with an…