Resumption of anticoagulation therapy (early or late) was associated with lower 1-year composite outcomes compared to no resumption, although it increased hemorrhagic events (p=0.028).
Observational (n=242)
Yes
Does the timing of anticoagulation therapy resumption affect clinical outcomes in patients with intracerebral hemorrhage and atrial fibrillation?
In patients with ICH and AF, resuming anticoagulation therapy is associated with improved 1-year composite outcomes compared to no resumption, with early resumption (≤7 days) appearing as safe and effective as late resumption despite an overall increased bleeding risk.
BACKGROUND: The efficacy of anticoagulation therapy in patients with intracerebral hemorrhage (ICH) and concomitant atrial fibrillation (AF) remains controversial. As the decision to resume anticoagulation therapy remains debated, the optimal timing for resumption has rarely been investigated. This study retrospectively explored the timing of anticoagulation initiation using data from a multicenter registry of eight stroke centers. METHODS: Clinical data of patients with ICH and AF, including the timing of anticoagulant initiation, baseline laboratory findings, prior antithrombotic use, treatment for ICH, and imaging findings (hematoma location, volume, expansion, and cerebral microbleeds), were retrospectively collected. Outcomes included the modified Rankin Scale (mRS) scores at discharge and after 3 months and a 1-year composite outcome of all-cause death, thromboembolic events, and hemorrhagic events. RESULTS: Among 2066 patients with ICH, 242 (11.7%) had AF. The median time to anticoagulation therapy initiation was 7 days (IQR, 3-14 days). Patients were classified into the early (≤7 days, n = 71), late (>7 days, n = 64), and no resumption (n = 107) groups. The early group showed significantly better mRS scores at discharge and 3 months (p < 0.0001). The composite outcome was more common in the no resumption group. Compared with no resumption, resumption (early or late) was associated with lower 1-year composite outcomes, whereas early versus late resumption showed no significant difference, although resumption was associated with an increase in hemorrhagic events (p = 0.028). CONCLUSIONS: The timing of anticoagulation therapy resumption was not significantly associated with 1-year outcomes. Early resumption may be safe, although long-term bleeding risk warrants caution.
Abe et al. (Tue,) conducted a observational in Intracerebral hemorrhage with concomitant atrial fibrillation (n=242). Early anticoagulation therapy resumption (≤7 days) vs. Late resumption (>7 days) or no resumption was evaluated on 1-year composite outcome of all-cause death, thromboembolic events, and hemorrhagic events. Resumption of anticoagulation therapy (early or late) was associated with lower 1-year composite outcomes compared to no resumption, although it increased hemorrhagic events (p=0.028).