Use of Anticoagulants Following Brain Hemorrhage in Atrial Fibrillation Patients

A meta-analysis of observational studies suggests no increased risk for hemorrhage recurrence and reduced risk for ischemic stroke with vitamin K antagonists but not with antiplatelet drugs.

In the setting of atrial fibrillation (AF), oral anticoagulation (OAC) reduces strokes by 60% to 70% and is one of the most effective stroke prevention options. OACs are associated with a small but finite risk for intracranial hemorrhage (ICH). Whether to resume OAC after ICH is a challenging decision that requires balancing the risk for an ischemic stroke with the chance of another brain hemorrhage.

These authors performed a systematic review of studies that reported recurrence rates for ICH and ischemic stroke rates in patients with an initial brain hemorrhage and AF. Included studies reported outcomes for at least 3 months. Patients were categorized according to whether they received vitamin K antagonists (VKA), antiplatelet medication, o…

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

Use of Anticoagulants Following Brain Hemorrhage in Atrial Fibrillation Patients

Topics

Reviewing Author