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Lancet Neurol: There is no conclusion yet-should patients with atrial fibrillation after spontaneous intracranial hemorrhage take oral anticoagulants?

 Last Update: 2021-11-01
 Source: Internet
 Author: User

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Oral vitamin K antagonist warfarin for myocardial infarction blood vessels reduces the risk of stroke in atrial fibrillation by about 64%

The NOAC study of stroke prevention with atrial fibrillation and the randomized feasibility study of 30 cases of previous intracerebral hemorrhage (NASPAF-ICH), and the phase 2 randomized trial of Apicaban (APACHE-AF) after anticoagulation-related cerebral hemorrhage in 101 patients with atrial fibrillation, The effects of oral anticoagulation and antiplatelet therapy or not receiving antithrombotic therapy were compared in participants with atrial fibrillation after intracerebral hemorrhage , but the safety and effectiveness are uncertain

Recently, a researcher initiated a randomized trial of starting or stopping anticoagulant drugs (SoSTART) for survivors of spontaneous intracranial hemorrhage with atrial fibrillation to determine the feasibility of deterministic randomized trials within an acceptable time scale.

Prospective, randomized, open labeling, evaluator blocking, parallel grouping, pilot phase trials

The main result is recurring symptomatic spontaneous intracranial hemorrhage and is judged by individuals who are double-blind for treatment assignment

Between March 29, 2018 and February 27, 2020, 218 participants obtained consent at 61 locations, of which 203 were randomly assigned to a median of 115 days (IQR 49-265) after the onset of intracranial hemorrhage Count

Although the recurrence rate of intracranial hemorrhage is lower than expected, it is still uncertain whether patients with atrial fibrillation after intracranial hemorrhage starting oral anticoagulation therapy are not inferior to avoiding anticoagulation therapy

SoSTART Collaboration.
Effects of oral anticoagulation for atrial fibrillation after spontaneous intracranial haemorrhage in the UK: a randomised, open-label, assessor-masked, pilot-phase, non-inferiority trial.
Lancet Neurol.
2021;20(10):842- 853.
doi:10.
1016/S1474-4422(21)00264-7

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