Long‐term anticoagulant therapy in cerebrovascular disease: does bleeding outweigh the benefit?

Dahl, T; Abildgaard, Ulrich; Sandset, Per Morten

doi:10.1111/j.1365-2796.1995.tb01182.x

Cited by 12 publications

(9 citation statements)

References 22 publications

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“…The reported mean incidence of major bleeding in the anticoagulated population is estimated to be 2.4% to 4.6% per year, and fatal hemorrhage incidence is 0.1% to 1.6% per year [22,[25][26][27][28][29].…”

Section: Anticoagulant Bleedingmentioning

confidence: 99%

Oral anticoagulant treatment: Risk factors involved in 500 intracranial hemorrhages

Cantalapiedra

Gutiérrez

Tortosa

et al. 2006

J Thromb Thrombolysis

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Intracranial bleeding is the most severe complication caused by anticoagulant or antiplatelet treatment. The increasing use of this therapy, especially in older people, makes the balance between clinical benefit and bleeding risk an important consideration. A retrospective study of all consecutive 500 intracranial hemorrhages in the West Valladolid area, approximately 220,000 people, during the period 1998 to 2004, was performed. In relation to mortality, predisposing conditions were included, such as age, antithrombotic treatment, arterial hypertension, cancer, blood diseases, vascular malformations, and traumatisms. The incidence of intracranial hemorrhage was 310 per 100,000 per year with a mortality of 30%. Higher mortality was found in antiplatelet-treated patients (44.9%) than in anticoagulated patients (31.1%). This may be related to a different mean age of 78 vs. 71 years. Arterial hypertension was the most frequent risk factor (45.1% in nontreated patients, 60% anticoagulated, and 75.5% antiplatelet). The relative risk of intracranial bleeding in anticoagulated patients was 11.2 (p < 0.001) with an incidence of 0.03% and a median of 14 months since treatment began. The median INR was 3.3. In 40% of the patients the previous five controls were in range. Strict consideration of indications criteria joined to a better control of risk factors may avoid intracranial bleeding episodes.

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Section: Anticoagulant Bleedingmentioning

confidence: 99%

Oral anticoagulant treatment: Risk factors involved in 500 intracranial hemorrhages

Cantalapiedra

Gutiérrez

Tortosa

et al. 2006

J Thromb Thrombolysis

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“…Therefore, SDH and intracerebral hemorrhage fatality rates when receiving no therapy 15,[23][24][25][26][27][28][29][30][31][32] and warfarin 15,17,19,23,24,[26][27][28][32][33][34][35][36][37][38][39][40] were estimated by pooling studies that reported consecutive cases. For persons receiving aspirin at the time of their SDH or intracerebral hemorrhage, information about their outcomes was not available.…”

Section: Discussionmentioning

confidence: 99%

Choosing Antithrombotic Therapy for Elderly Patients With Atrial Fibrillation Who Are at Risk for Falls

Man-Son-Hing

Nichol²,

Lau³

et al. 1999

Arch Intern Med

470

238

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Objective: To determine whether the risk of falling (with a possible increased chance of subdural hematoma) should influence the choice of antithrombotic therapy in elderly patients with atrial fibrillation.Design: A Markov decision analytic model was used to determine the preferred treatment strategy (no antithrombotic therapy, long-term aspirin use, or longterm warfarin use) for patients with atrial fibrillation who are 65 years of age and older, are at risk for falling, and have no other contraindications to antithrombotic therapy. Input data were obtained by systematic review of MED-LINE. Outcomes were expressed as quality-adjusted lifeyears.

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“…Estimations of its frequency range from 0.3 to 4.6% per year (1,2). The absolute rate of ICH in patients older than age 60 years who are treated with conventional intensities of anticoagulation ranges from 0.3 to 1% per year, and 60% of cases are fatal (3).…”

Section: Introductionmentioning

confidence: 99%

Use of Recombinant Factor VIIa in Patients With Warfarin-Associated Intracranial Hemorrhage

Brody

Aiyagari

Shackleford

et al. 2005

NCC

132

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Long‐term anticoagulant therapy in cerebrovascular disease: does bleeding outweigh the benefit?

Cited by 12 publications

References 22 publications

Oral anticoagulant treatment: Risk factors involved in 500 intracranial hemorrhages

Oral anticoagulant treatment: Risk factors involved in 500 intracranial hemorrhages

Choosing Antithrombotic Therapy for Elderly Patients With Atrial Fibrillation Who Are at Risk for Falls

Use of Recombinant Factor VIIa in Patients With Warfarin-Associated Intracranial Hemorrhage

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