Stroke. 2022 Jul;53(7):2152-2160. doi: 10.1161/STROKEAHA.122.036888. Epub 2022 Jun 27.
Optimal antithrombotic management after intracerebral hemorrhage remains one of the central unresolved issues for patients who survive, especially for those patients with atrial fibrillation. Given the observational nature of the studies regarding anticoagulation resumption after intracerebral hemorrhage, there is uncertainty regarding resumption of oral anticoagulation therapy and its timing. There is limited high-quality evidence to guide clinical practice, leading to significant practice variation and uncertainty for patients and providers. Here, we aim to provide the key elements to guide clinicians in their individual decision: whether or not to start or resume anticoagulation in patients with a history of intracerebral hemorrhage.
脑出血后最佳抗栓管理仍然是幸存者面临的核心未解决问题之一,尤其是那些患有心房颤动的患者。鉴于关于脑出血后恢复抗凝的研究具有观察性,因此对于恢复口服抗凝治疗及其时机存在不确定性。目前仅有有限的高质量证据来指导临床实践,这导致患者和提供者的实践差异和不确定性很大。在这里,我们旨在提供指导临床医生做出个体化决策的关键要素:对于有脑出血病史的患者,是否开始或恢复抗凝。