Oral anticoagulation (OAC) therapy is linked with a reduced risk for thromboembolic events and all-cause mortality without notably increasing risk for recurrent intracranial hemorrhage (ICrH) in ICrH survivors with atrial fibrillation (AF), according to a study published in Stroke. Deirdre A. Lane, PhD, and colleagues conduced a systematic review and meta-analysis (20 articles; N=50,470 participants) to evaluate the safety and efficacy of OAC and/or anti-platelets in patients with AF with nontraumatic ICrH. OAC therapy was linked with a considerable reduction in thromboembolic events (summary relative risk [sRR], 0.51 [95% CI, 0.30–0.86]), and all-cause mortality (sRR, 0.52 [95% CI, 0.38–0.71]). No association was found between OAC therapy and increased risk for recurrent ICrH (sRR, 1.44 [95% CI, 0.38–5.46]; heterogeneity I2=70%; P=0.02). Non-vitamin K antagonist OACs were more useful at lowering the risk for thromboembolic events (sRR, 0.65 [95% CI, 0.44–0.97]; heterogeneity I2=72%; P=0.03) and, compared with warfarin, were linked with a lower risk for recurrent ICrH (sRR, 0.52 [95% CI, 0.40–0.67]).
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