uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Antithrombotic Treatment Following Intracerebral Hemorrhage in Patients With and Without Atrial Fibrillation
Show others and affiliations
2015 (English)In: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 46, no 8, 2094-2099 p.Article in journal (Refereed) Published
Abstract [en]

Background and Purpose-Patients who survive intracerebral hemorrhage (ICH) often have compelling indications for anticoagulant and antiplatelet medication. This nationwide observational study aimed to determine the extent and predictors of antithrombotic treatment after ICH in Sweden. Methods-Patients with a first-ever ICH in the Swedish Stroke Register (Riksstroke) 2005 to 2012 who survived hospital discharge were included. Riksstroke data were individually linked with other national registers to determine comorbid conditions and dispensed prescriptions of antithrombotic agents. Results-Among the 2777 patients with atrial fibrillation (AF), the proportion with a dispensed prescription of antithrombotic agents was 8.5% (anticoagulants) and 36.6% (antiplatelet agents) within 6 months and 11.1% (anticoagulants) and 43.6% (antiplatelet agents) within 1 year. Among the 11 268 patients without AF, the corresponding figures were 1.6% (anticoagulants) and 13.8% (antiplatelet agents) within 6 months and 2.0% (anticoagulants) and 17.5% (antiplatelet agents) within 1 year. In patients with AF, predictors of anticoagulant treatment were less severe ICH, younger age, previous anticoagulation, valvular disease, and previous ischemic stroke. High CHA(2)DS(2)-VASc (congestive heart failure, hypertension, age, diabetes mellitus, stroke [doubled], vascular disease, age, and sex category [female]) scores did not correlate with anticoagulant treatment. There was a positive correlation between high CHA(2)DS(2)-VASc and HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, elderly, drugs/alcohol) scores (r(s)=0.590, P<0.001). Conclusions-In majority of patients who receive antithrombotic agents, treatment is initiated within 6 months of ICH. Still, many patients with compelling indications for antithrombotic treatment are not prescribed antithrombotic agents. Factors other than high risk of embolic stroke by CHA(2)DS(2)-VASc in ICH survivors with concurrent AF are used to guide the anticoagulant treatment decision in Swedish clinical practice.

Place, publisher, year, edition, pages
2015. Vol. 46, no 8, 2094-2099 p.
Keyword [en]
anticoagulation, antiplatelet agent, atrial fibrillation, intracerebral hemorrhage
National Category
Cardiac and Cardiovascular Systems
URN: urn:nbn:se:uu:diva-262439DOI: 10.1161/STROKEAHA.115.009087ISI: 000359972200026PubMedID: 26159794OAI: oai:DiVA.org:uu-262439DiVA: diva2:854340
Swedish Research Council, 2011-2395
Available from: 2015-09-16 Created: 2015-09-15 Last updated: 2015-09-16Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed
By organisation
Cardiovascular epidemiology
In the same journal
Cardiac and Cardiovascular Systems

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 169 hits
ReferencesLink to record
Permanent link

Direct link