Resuming Anticoagulation After Cerebral Intraparenchymal Hemorrhage

To the Editor Dr Gross and colleagues reviewed the management options for cerebral intraparenchymal hemorrhage (IPH) to help guide clinical decision-making. The review captured the most up-to-date evidence for clinical management of IPH; however, the authors ’ suggestion to resume oral anticoagulation therapy 1 to 2 months after deep IPH unrelated to cerebral amyloid angiopathy may not be supported by firm evidence. We believe the recommendations should be more cautious. The 2015 American Heart Association guidelines do not provide a definitive recomm endation for resumption of anticoagulation therapy after nonlobar IPH. In the absence of results from randomized clinical trials, the safety and optimal timing of restarting oral anticoagulation therapy in patients with IPH remains unknown.
Source: JAMA - Category: General Medicine Source Type: research