April 1, 1998Neurosurgery
The Dilemma of Discontinuation of Anticoagulation Therapy for Patients with Intracranial Hemorrhage and Mechanical Heart Valves
Key result
Temporary discontinuation of anticoagulation therapy in patients with mechanical heart valves and intracranial hemorrhage resulted in 0 ischemic events and 0 hemorrhage recurrences.
Why the study?
Does temporary discontinuation of anticoagulation therapy prevent recurrent hemorrhage without increasing thromboembolic risk in patients with intracranial hemorrhage and mechanical heart valves?
Population
39 patients with intracranial hemorrhage and mechanical heart valves (median age 69 years)
Design
Case_series
Follow-up
during hospitalization
Authors
Discussion
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Implication
Should not yet change practice; leaves open need for prospective trials on brief anticoagulation interruption in mechanical valve patients with ICH.
Key Points
- The research aims to evaluate the safety of temporary discontinuation of anticoagulation therapy in patients experiencing intracranial hemorrhage and having mechanical heart valves.
- Reviewed medical records and neuroimaging studies of patients with intracranial hemorrhage and mechanical heart valves
- Examined neurological data and cardiac risk factors for systemic embolization
- Analyzed hospital management strategies for patients
- Studied 39 patients with intracranial hemorrhage (median age 69 years) with varying types of hemorrhage
- None of the patients developed ischemic strokes or systemic embolization during their hospitalization
- Temporary interruption of anticoagulation therapy was deemed safe; none experienced recurrence of hemorrhage or valve thrombosis.
Study Design
Type
Observational (n=39)
Structured PICO
Does temporary discontinuation of anticoagulation therapy prevent recurrent hemorrhage without increasing thromboembolic risk in patients with intracranial hemorrhage and mechanical heart valves?
P
Population
39 patients (median age 69 years) with mechanical heart valves admitted with intracranial hemorrhage who underwent temporary discontinuation of anticoagulation therapy.
E
Exposure
Temporary discontinuation of anticoagulation therapy (median duration 8 days) and reversal with fresh frozen plasma and vitamin K
O
Outcome
Occurrence of transient ischemic attacks, ischemic strokes, valve thrombosis, systemic embolization, or recurrence of intracranial hemorrhage during hospitalizationsafety
Temporary interruption of anticoagulation for 1 to 2 weeks appears safe in patients with mechanical heart valves who experience an intracranial hemorrhage, without causing thromboembolic events.
Cite This Study
Wijdicks et al. (1998) conducted an observational in Intracranial hemorrhage and mechanical heart valves (n=39). Temporary discontinuation of anticoagulation therapy was evaluated on Transient ischemic attacks, ischemic strokes, valve thrombosis, systemic embolization, or recurrence of intracranial hemorrhaging. Temporary discontinuation of anticoagulation therapy in patients with mechanical heart valves and intracranial hemorrhage resulted in 0 ischemic events and 0 hemorrhage recurrences.