Inconclusive Findings in Non-Vitamin K Antagonist Oral Anticoagulants Study

To the Editor In their population-based cohort study using Taiwan ’s National Health Insurance Research Database, Tsai et al report no excess risk of intracranial hemorrhage (ICH) associated with treatment compared with no treatment with non-vitamin K antagonist oral anticoagulants (NOACs) in patients with acute ischemic stroke receiving intravenous alteplase. W e applaud the authors’ efforts to build on the evidence on the safety of thrombolysis in patients receiving NOACs; however, we wonder about potential issues of exposure and outcome misclassification producing results that are biased toward the null hypothesis.
Source: JAMA Internal Medicine - Category: Internal Medicine Source Type: research