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Advances in the medical treatment and diagnosis of intracranial hemorrhage associated with oral anticoagulation.

Author information

Affiliations

  • 1. Department of Cardiology, Hospital Clínico Universitario Virgen De La Arrixaca, Murcia, Spain.
      Authors
    • Piqueras-Sanchez C 1
    • Esteve-Pastor MA 1, 2
    • Moreno-Fernandez J 1
    • Marín F 1, 2
    (4 authors)
  • 2. Instituto Murciano De Investigación Biosanitaria (IMIB- Arrixaca), Murcia, Spain.
      Authors
    • Esteve-Pastor MA 1, 2
    • Soler-Espejo E 2
    • Rivera-Caravaca JM 2
    • Roldán V 2
    • Marín F 1, 2
    (5 authors)

ORCIDs linked to this article

Expert Review of Neurotherapeutics, 22 Jul 2024, 24(9):913-928
https://doi.org/10.1080/14737175.2024.2379413 PMID: 39039686 

Review

Abstract 

Introduction

With the increasing prevalence of atrial fibrillation (AF), it entails expanding oral anticoagulants (OACs) use, carrying a higher risk of associated hemorrhagic events, including intracranial hemorrhage (ICH). Despite advances in OACs development with a better safety profile and reversal agent for these anticoagulants, there is still no consensus on the optimal management of patients with OACs-associated ICH.

Areas covered

In this review, the authors have carried out an exhaustive search on the advances in recent years. The authors provide an update on the management of ICH in anticoagulated patients, as well as an update on the latest evidence on anticoagulation resumption, recent therapeutic strategies, and investigational drugs that could play a role in the future.

Expert opinion

Following an ICH event in an anticoagulated patient, a comprehensive clinical evaluation is imperative. Anticoagulation should be promptly withdrawn and reversed. Once the patient is stabilized, a reintroduction of anticoagulation should be considered, typically within a timeframe of 4-8 weeks, if feasible. If re-anticoagulation is not possible, alternative options such as Left Atrial Appendage Occlusion are available.

Full text links 

Read article at publisher's site: https://doi.org/10.1080/14737175.2024.2379413

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Funding 

Funders who supported this work.

Centro De Investigacion Biomedica En Red Enfermedades Cardiovasculares

    European Regional Development Fund and group (1)

    Instituto de Salud Carlos III (1)

    Ministry of Economy