Restarting Anticoagulant Therapy After Intracerebral Hemorrhage — Still a Quandary

One-year outcomes were better after restarting warfarin in patients with either lobar or nonlobar ICH, but randomized trials are needed.

Whether and when to resume oral anticoagulation therapy after intracerebral hemorrhage (ICH) is still a predicament. Existing data often are unable to provide clear guidance, leaving clinicians to rely on individual experiences, preferences, and limited data on potential factors such as ICH location (lobar/nonlobar) and the clinical suspicion of cerebral amyloid angiopathy (CAA).

In a meta-analysis of patient-level data from three observational cohorts (RETRACE, ERICH, and MGH), investigators identified 1012 survivors of first-time warfarin-related ICH (INR >1.5) who were candidates for resuming anticoagulation for nonvalvular atrial fibrillation. Anticoagulation was resumed for 23% (87/379) of lobar ICH patients and 28% (178/633) of nonloba…

Reviewing Authors

Anthony S. Kim, MD

Disclosures

Grant/Research SupportNIH/National Institute of Neurological Disorders and Stroke; NIH/National Center for Advancing Translational Sciences

Anthony S. Kim, MD

Disclosures

Grant/Research SupportNIH/National Institute of Neurological Disorders and Stroke; NIH/National Center for Advancing Translational Sciences

Roger Cheng, MD

Restarting Anticoagulant Therapy After Intracerebral Hemorrhage — Still a Quandary

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Reviewing Authors