Key result
NOACs were associated with a nonsignificant lower 1-year risk of ischemic stroke (RR 0.52) compared with warfarin in patients with atrial fibrillation sustaining an intracerebral hemorrhage.
Why the study?
Recurrent bleeding associated with oral anticoagulants causes a clinical dilemma in patients with AF sustaining an intracerebral hemorrhage, and treatment recommendations guiding optimal OAC selection are lacking.
Does NOAC treatment reduce ischemic stroke and recurrent intracerebral hemorrhage compared to warfarin in patients with atrial fibrillation sustaining an intracerebral hemorrhage?
Population
622 AF patients sustaining an intracerebral hemorrhage who subsequently claimed an OAC prescription
Comparison
NOAC vs warfarin
Design
Nationwide observational cohort study
Follow-up
1 year
Authors
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Does not support practice change after ICH in AF; leaves open whether NOACs reduce ischemic stroke versus warfarin.
Cohort (n=622)
Does NOAC treatment reduce ischemic stroke and recurrent intracerebral hemorrhage compared to warfarin in patients with atrial fibrillation sustaining an intracerebral hemorrhage?
Effect estimate: RR 0.52 (95% CI 0.27-1.00)
Absolute Event Rate: 4.01% vs 7.85%
In patients with atrial fibrillation and a recent intracerebral hemorrhage, NOACs were associated with a non-significant reduction in both ischemic stroke and recurrent intracerebral hemorrhage compared to warfarin.
Nielsen et al. (2019) conducted a cohort in Atrial fibrillation with intracerebral hemorrhage (n=622). Non-vitamin K antagonist oral anticoagulants (NOACs) vs. Warfarin was evaluated on Ischemic stroke at 1 year (RR 0.52, 95% CI 0.27-1.00). NOACs were associated with a nonsignificant lower 1-year risk of ischemic stroke (RR 0.52) compared with warfarin in patients with atrial fibrillation sustaining an intracerebral hemorrhage.
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