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Outcome after intracranial hemorrhage under dabigatran and reversal with idarucizumab versus under vitamin-K-antagonists – the RIC-ICH study
ConclusionThese results, based on data from routine clinical practice, suggest that in-hospital mortality after idarucizumab treatment is comparable to that in patients pretreated with VKA. Due to the low precision of estimates, the results must be interpreted with caution.
Source: Frontiers in Neurology - July 24, 2023 Category: Neurology Source Type: research

Long-term stroke and major bleeding risk in patients with non-valvular atrial fibrillation: A comparative analysis between non-vitamin K antagonist oral anticoagulants and warfarin using a clinical data warehouse
ConclusionsIn this CDW based study, NOACs are more effective and safer than warfarin in patients with AF even with long-term follow-up. NOACs should be used to prevent ischemic stroke in patients with AF
Source: Frontiers in Neurology - January 26, 2023 Category: Neurology Source Type: research

Impact of type of oral anticoagulants in patients with cerebral microbleeds after atrial fibrillation-related ischemic stroke or TIA: Results of the NOACISP-LONGTERM registry
ConclusionsIn AF-stroke patients treated with OAC, the presence of CMBs was associated with an unfavorable composite outcome for both VKAs and DOACs, with a higher risk for recurrent IS than for ICH. Strokes were numerically higher under VKAs and increased in the presence of CMBs.Clinical trial registrationhttp://www.clinicaltrials.gov, Unique identifier: NCT03826927.
Source: Frontiers in Neurology - September 20, 2022 Category: Neurology Source Type: research

Bridging intravenous thrombolysis in patients with atrial fibrillation
ConclusionBridging IVT appears to be a reasonable clinical option in selected patients with AF. Given the increased sICH risk in patients with VKA, subgroup analysis of the randomized controlled trials should analyze whether patients with VKA might benefit from withholding bridging IVT.Registrationclinicaltrials.gov; Unique identifier: NCT03496064.
Source: Frontiers in Neurology - August 3, 2022 Category: Neurology Source Type: research

Comorbidities and Antithrombotic Treatment Pattern in Patients With Atrial Fibrillation
ConclusionsThe treatment pattern of antithrombotics did not change with the introduction of NOACs. However, comorbidities served as an important factor in choosing treatment regardless of NOAC entry.
Source: Frontiers in Neurology - March 4, 2022 Category: Neurology Source Type: research

Sex-Differences in Oral Anticoagulant-Related Intracerebral Hemorrhage
ConclusionSignificant sex-differences were observed in age, risk factors, access to treatment, and DNRs while no significant differences were observed in comorbidity burden, stroke severity, or hematoma volume. Outcomes, such as adjusted mortality, ability to walk, and neurological deterioration, were comparable. This study supports the presence of sex-differences in risk factors and care but not in presentation and outcomes.
Source: Frontiers in Neurology - March 3, 2022 Category: Neurology Source Type: research

Warfarin Treatment Is Associated to Increased Internal Carotid Artery Calcification
Conclusions: Long-lasting warfarin anticoagulation associated with increased calcification of carotid atherosclerotic plaques, particularly in locations known to be the predilection sites of stroke-causing plaques. The clinical significance of this novel finding warrants further investigations.
Source: Frontiers in Neurology - July 12, 2021 Category: Neurology Source Type: research

Clinical Outcome in Patients With Intracerebral Hemorrhage Stratified by Type of Antithrombotic Therapy
Conclusions: Patients with antithrombotic therapy have worse clinical outcome after ICH. Patients using VKA have higher risk of poor outcome and mortality compared to patients using AP. These findings highlight the deleterious effect of antithrombotic therapy in patients with ICH and stress the need for effective therapies for ICH patients.
Source: Frontiers in Neurology - June 7, 2021 Category: Neurology Source Type: research

Non-vitamin K Oral Anticoagulants and Anti-seizure Medications: A Retrospective Cohort Study
Conclusions: The recurrent stroke rate of NOAC users with potential DDIs was not higher than in those without potential DDIs in this single-institute study. Our results suggest that theoretical interactions between ASMs and NOACs may not be as severe as previously thought in a real-world situation.
Source: Frontiers in Neurology - February 26, 2021 Category: Neurology Source Type: research

Oral Anticoagulation and Risk of Symptomatic Hemorrhagic Transformation in Stroke Patients Treated With Mechanical Thrombectomy: Data From the Nordictus Registry
Conclusions: OAC with VKA, but not with DOACs, was an independent predictor of sICH after mechanical thrombectomy. This excess risk was associated neither with INR value by the time thrombectomy was performed, nor with a worse functional outcome or mortality at 3 months.
Source: Frontiers in Neurology - November 26, 2020 Category: Neurology Source Type: research

Long-Term Anticoagulation in Secondary Ischemic Stroke Prevention: The Prospective Multicenter RESTAIC Registry
Conclusion: Long-term OAC in secondary stroke prevention is associated with a lower frequency of bleeding complications than stroke recurrences. No differences between anticoagulant drugs were found in any of the analyzed outcomes. The main cause for OAC switch during follow-up was stroke recurrence.
Source: Frontiers in Neurology - October 19, 2020 Category: Neurology Source Type: research

Vitamin K Antagonist Use and Risk for Intracranial Carotid Artery Calcification in Patients With Intracerebral Hemorrhage
Conclusions: Our findings do not support VKA use as an independent risk factor for higher ICAC degree in patients with ICH. We could not confirm the concerns about VKA use and intracranial carotid vascular calcification. We suggest further research in other cohorts with VKA users such as patients with ischemic stroke and atrial fibrillation.
Source: Frontiers in Neurology - December 19, 2019 Category: Neurology Source Type: research

Effects of Dabigatran in Mouse Models of Aging and Cerebral Amyloid Angiopathy
Oral anticoagulants are a critical component of stroke prevention, but carry a risk of brain hemorrhage. These hemorrhagic complications tend to occur in elderly individuals, especially those with predisposing conditions such as cerebral amyloid angiopathy (CAA). Clinical evidence suggests that non-vitamin K antagonist oral anticoagulants are safer than traditional oral anticoagulants. We analyzed whether the anticoagulant dabigatran produces cerebral microhemorrhage (the pathological substrate of MRI-demonstrable cerebral microbleeds) or intracerebral hemorrhage in aged mice with and without hemorrhage-predisposing angiop...
Source: Frontiers in Neurology - September 26, 2019 Category: Neurology Source Type: research

Impact of Non-vitamin K Antagonist Oral Anticoagulant Withdrawal on Stroke Outcomes
Joong Hyun Park, Sang Won Han, Kyung-Yul Lee, Hye-Yeon Choi, Kyeongyeol Cheon, Han-Jin Cho, Yo Han Jung, Hyung Jong Park, Hyo Suk Nam, Ji Hoe Heo, Hye Sun Lee, Gustavo Saposnik, Young Dae Kim
Source: Frontiers in Neurology - December 18, 2018 Category: Neurology Source Type: research