Ischemic and Bleeding Events After Early Initiation of Direct Oral Anticoagulants for Acute Intracranial Hemorrhage With Non-Valvular Atrial Fibrillation　― A Multicenter Prospective Registry ―

Masatoshi Koga; Kazunori Toyoda; Yasuyuki Iguchi; Ryo Itabashi; Hiroharu Kataoka; Michikazu Nakai; Kanta Tanaka; Kaori Miwa; Rei Kondo; Tatemi Todaka; Naoto Kimura; Kunikazu Yoshimura; Shigeo Yamashiro; Takahiro Ogishima; Yuka Terasawa; Nobukazu Komoribayashi; N Sakai; Makoto Hayase; Kenji Fukuda; Kazutaka Sonoda; Joji Hagii; Teruyuki Hirano; Fumio Miyashita; Hiroyuki Ohnishi; Kazumi Kimura; Toshihiro Ueda; Keiko Maezono-Kandori; Yukako Yazawa; Masanori Kinosada; Tsuyoshi Izumo; Shouhei Noshiro; Hikaru Nagasawa; Kuniyasu Wada; Hiroshi Yamagami; Ryo Itabshi; Yasushi Takagi; Yasuhiro Ito; Kumiko Sugio; Atsushi Takita; Tetsuya Kimura; Martin Unverdorben; Masafumi Ihara; Shigeru Fujimoto; Ashkan Shoamanesh; on behalf of the SAFE-ICH Registry Group

doi:10.1253/circj.cj-25-0791

February 24, 2026Circulation JournalOpen Access

Ischemic and Bleeding Events After Early Initiation of Direct Oral Anticoagulants for Acute Intracranial Hemorrhage With Non-Valvular Atrial Fibrillation　― A Multicenter Prospective Registry ―

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Key Points

This research assesses the risks of ischemic and hemorrhagic events following the early initiation of direct oral anticoagulants in patients with atrial fibrillation after intracranial hemorrhage.
Multicenter prospective registry study
Evaluation of ischemic and hemorrhagic events
Focus on patients with non-valvular atrial fibrillation post-intracranial hemorrhage
Increased ischemic risks noted post-early DOAC initiation
Bleeding events also elevated after ICH
Efficacy and safety of early DOAC use remain uncertain for this population

Implication

Multicenter registry shows increased ischemic and hemorrhagic risks after early DOAC initiation in patients with atrial fibrillation post-ICH, suggesting cautious use.

Abstract

Background: The efficacy and safety of early direct oral anticoagulant (DOAC) (re)initiation in patients with non-valvular atrial fibrillation (NVAF) after acute onset of intracranial hemorrhage (ICH) are unknown. This study evaluated ischemic and hemorrhagic risks following early DOAC (re)initiation after ICH in patients with NVAF.

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Cite This Study

Koga et al. (2026) studied this question.

synapsesocial.com/papers/699f956d1bc9fecf3dab33bd https://doi.org/10.1253/circj.cj-25-0791

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Ischemic and Bleeding Events After Early Initiation of Direct Oral Anticoagulants for Acute Intracranial Hemorrhage With Non-Valvular Atrial Fibrillation　― A Multicenter Prospective Registry ―

Key Points

Implication

Abstract

Discussion

Cite This Study

Ischemic and Bleeding Events After Early Initiation of Direct Oral Anticoagulants for Acute Intracranial Hemorrhage With Non-Valvular Atrial Fibrillation　― A Multicenter Prospective Registry ―

Key Points

Implication

Abstract

Discussion

Cite This Study

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Keep reading

Ischemic and Bleeding Events After Early Initiation of Direct Oral Anticoagulants for Acute Intracranial Hemorrhage With Non-Valvular Atrial Fibrillation ― A Multicenter Prospective Registry ―

Key Points

Implication

Abstract

Discussion

Cite This Study

Ischemic and Bleeding Events After Early Initiation of Direct Oral Anticoagulants for Acute Intracranial Hemorrhage With Non-Valvular Atrial Fibrillation ― A Multicenter Prospective Registry ―

Key Points

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading

Ischemic and Bleeding Events After Early Initiation of Direct Oral Anticoagulants for Acute Intracranial Hemorrhage With Non-Valvular Atrial Fibrillation　― A Multicenter Prospective Registry ―

Ischemic and Bleeding Events After Early Initiation of Direct Oral Anticoagulants for Acute Intracranial Hemorrhage With Non-Valvular Atrial Fibrillation　― A Multicenter Prospective Registry ―