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Patients with atrial fibrillation are at increased risk of thromboembolism, especially those with a CHA2DS2-VASc score ≥2; therefore, oral anticoagulant (OAC) therapy is often recommended according to different guidelines
.
However, OAC therapy increases the risk of bleeding
The aim of this study was to investigate the efficacy and safety of discontinuing or restarting antithrombotic drugs and different antithrombotic treatments in patients with atrial fibrillation after intracranial hemorrhage
.
This is a nationwide retrospective cohort study of patients with atrial fibrillation receiving antithrombotic therapy and subsequent intracranial hemorrhage between January 1, 2011, and December 31, 2017
.
The researchers investigated mortality between untreated patients and those who were reintroduced to oral anticoagulants (OACs) or antiplatelet drugs, and between warfarin and non-vitamin K antagonist OACs
Compared with no treatment, OAC reduced the risk of IS (HR 0.
61; 0.
42-0.
89) without increasing the risk of ICH (1.
15, 0.
66-2.
02); antiplatelet drug users showed a similar risk of IS (1.
13, 0.
66-2.
02) 0.
81-1.
56) and increased ICH risk (1.
81, 1.
07-3.
04)
.
The use of OACs or antiplatelet drugs did not reduce the risk of all-cause mortality (0.
CONCLUSIONS: OACs are recommended for patients with atrial fibrillation and intracranial hemorrhage because they reduce the risk of IS without increasing the risk of subsequent ICH
.
The recommended non-vitamin K antagonists, OACs, are preferred to warfarin because of their survival advantage
OACs are recommended for patients with atrial fibrillation and intracranial hemorrhage because they reduce the risk of IS without increasing the risk of subsequent ICH
Original source:
Shin‐Yi Lin.
