Anti-thrombotic therapy in patients with atrial fibrillation and intracranial hemorrhage
Abstract
Patients with atrial fibrillation have an increased risk of ischemic stroke that can be dramatically lowered by treatment with anticoagulants. The annual rate of major bleeds with warfarin averages about 2%. The rates of intracerebral and intracranial bleeds are significantly reduced with the use of the novel direct oral anticoagulants (DOACs) compared with warfarin. Treatment of anticoagulation-related intracerebral hemorrhage is based on the results of case series and small trials. Resumption of anticoagulation in patients with atrial fibrillation who had an intracerebral bleed depends on the etiology and location of the bleeding and the absolute rate of stroke in the absence of anticoagulation.
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Systemic thrombolysis is contraindicated in patients on therapeutic oral anticoagulation.
“Systemic thrombolysis is contraindicated in patients on therapeutic OAC.472,473”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [472]
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Shirasaki, Y., MORISHIMA, Y., & Shibano, T. (2013) · Thrombosis Research · doi:10.1016/j.thromres.2013.07.015 · Cited by 10 · see citing works
Huttner, B. D., Kanter, C., Staykov, D., Köhrmann, M., Struffert, T., Richter, G., Bardutzky, J., Kollmar, R., Schellinger, P. D., Dörfler, A., et al. (2008) · Aktuelle Neurologie · doi:10.1055/s-0028-1086569 · Cited by 9 · see citing works
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Reservations against new oral anticoagulants after stroke and cerebral bleeding
Stöllberger, C., & Finsterer, J. (2013) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2013.03.017 · Cited by 7 · see citing works
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2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P. F., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castellà, M., Diener, H., Heidbüchel, H., Hendriks, J., et al. (2016) · EP Europace · doi:10.1093/europace/euw295 · Cited by 6,438 · see citing works
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw210 · Cited by 6,418 · see citing works
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Journal of Cardio-Thoracic Surgery · doi:10.1093/ejcts/ezw313 · Cited by 1,403 · see citing works
2020 Clinical guidelines for Atrial fibrillation and atrial flutter
Arakelyan, M. S., Bockeria, L. A., Vasilieva, E., Sp, G., Golukhova, E. Z., Gorev, M. V., Davtyan, K. V., Drapkina, O. M., Станиславовна, К. Е., Kuchinskaya, Е. А., et al. (2021) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2021-4594 · Cited by 255 · see citing works
Oral Anticoagulant Therapy in Atrial Fibrillation Patients at High Stroke and Bleeding Risk
Potpara, T., & Lip, G. Y. H. (2015) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2015.07.003 · Cited by 51 · see citing works
2025 Clinical practice guidelines for Atrial fibrillation and flutter
Golukhova, E. Z., Sp, G., Михайлов, Е. Н., Revishvili, A. S. H., Arakelyan, M. G., Vasilyeva, E. Y., Davtyan, K. V., Drapkina, O. M., Drozdova, L. Y., Станиславовна, К. Е., et al. (2026) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2025-6668 · Cited by 44 · see citing works
European guidelines on perioperative venous thromboembolism prophylaxis
Ahmed, A. B., Kozek‐Langenecker, S. A., Mullier, F., Pavord, S. R., & Hermans, C. R. J. R. (2017) · European Journal of Anaesthesiology · doi:10.1097/eja.0000000000000725 · Cited by 23 · see citing works
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Petrov, V. I., Герасименко, А. С., Gorbatenko, V. S., & Shatalova, O. V. (2021) · Pharmacy & Pharmacology · doi:10.19163/2307-9266-2020-8-4-222-232 · Cited by 1 · see citing works
Antithrombotic Therapy in Patients with Recent Stroke and Atrial Fibrillation
Saberwal, B., Ioannou, A., Lim, W. Y., Beirne, A., CHOW, A. W. C., Tousoulis, D., Ahsan, S., & Παπαγεωργίου, Ν. (2020) · Current Pharmaceutical Design · doi:10.2174/1381612826666200407150307 · Cited by 1 · see citing works
Anticoagulation therapy in atrial fibrillation after intracranial hemorrhage
Герасименко, А. С., Gorbatenko, V. S., Shatalova, O. V., & Petrov, V. I. (2021) · Rational Pharmacotherapy in Cardiology · doi:10.20996/1819-6446-2021-04-13
- Authors
- Diener, H.-C., Stanford, S., Abdul-Rahim, A., Christensen, L., Hougaard, K. D., Bakhai, A., Veltkamp, R., & Worthmann, H.
- Affiliations
- Essen University Hospital (DE)
- Swansea University (GB)
- Bispebjerg Hospital (DK)
- Aarhus University Hospital (DK)
- The Royal Free Hospital (GB)
- Heidelberg University (DE)
- Medizinische Hochschule Hannover (DE)
- Corresponding author
- Diener, Hans-Christoph
- Venue
- Expert Review of Neurotherapeutics
- Publisher
- Informa UK Limited
- Published
- 2014-08-04
- Volume
- 14
- Issue
- 9
- Pages
- 1019-1028
- ISSN
- 1473-7175 (ISSN-L)
- 1744-8360
- OpenAlex
- W2065364257
- Cited by
- 12
- References
- 95
- Citations by year
- 2026: 1 · 2021: 3 · 2020: 1 · 2017: 2 · 2016: 3 · 2015: 2
- FWCI
- 0.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Expert Review of Neurotherapeutics (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Neurology › Intracerebral and Subarachnoid Hemorrhage Research
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Keywords
- atrial fibrillation, intracerebral hemorrhage, anticoagulation, direct oral anticoagulants, warfarin, antithrombotic therapy, ischemic stroke prevention, bleeding risk, anticoagulation resumption, hemorrhagic stroke
- MeSH terms
- Animals, Atrial Fibrillation, Fibrinolytic Agents, Humans, Intracranial Hemorrhages
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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