When and How to Resume Anticoagulation After Brain Hemorrhage in Patients with Mechanical Valves

Withholding anticoagulation for 7 days appears safe in this patient population.

Development of intracerebral hemorrhage (ICH) in patients with mechanical heart valves who are being treated with oral anticoagulants is a feared complication. Deciding when to resume oral anticoagulant treatment is challenging, since the clinician needs to balance the risk for ischemic stroke while off anticoagulant treatment with the risk for worsening ICH with the use of anticoagulants. These researchers conducted a three-center, retrospective study of 171 patients (median age, 75 years; 68% women) with ICH while on oral anticoagulant treatment for mechanical valves, identified over a 22-year period. The authors assessed the rate of stroke while off anticoagulants, the rate of hematoma expansion after anticoagulant resumption, and short-…

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

When and How to Resume Anticoagulation After Brain Hemorrhage in Patients with Mechanical Valves

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Reviewing Author