Risk Factors for Intracerebral Hemorrhage in Patients With Atrial Fibrillation on Non–Vitamin K Antagonist Oral Anticoagulants for Stroke Prevention | Zendy

Maurizio Paciaroni | Zendy; Giancarlo Agnelli | Zendy; Michela Giustozzi | Zendy; Valeria Caso | Zendy; Elisabetta Toso | Zendy; Filippo Angelini | Zendy; Isabella Canavero | Zendy; Giuseppe Micieli | Zendy; Kateryna Antonenko | Zendy; Alessandro Rocco | Zendy; Marina Diomedi | Zendy; Aristeidis H. Katsanos | Zendy; Ashkan Shoamanesh | Zendy; Sotirios Giannopoulos | Zendy; Walter Ageno | Zendy; Samuela Pegoraro | Zendy; Jukka Putaala | Zendy; Daniel Strbian | Zendy; Hanne Sallinen | Zendy; Brian Mac Grory | Zendy; Karen L. Furie | Zendy; Christoph Stretz | Zendy; Michael Reznik | Zendy; Andrea Alberti | Zendy; Michele Venti | Zendy; Maria Giulia Mosconi | Zendy; Maria Cristina Vedovati | Zendy; Laura Franco | Zendy; Giorgia Zepponi | Zendy; Michele Romoli | Zendy; Andrea Zini | Zendy; Laura Brancaleoni | Zendy; Letizia Riva | Zendy; Giorgio Silvestrelli | Zendy; Alfonso Ciccone | Zendy; Marialuisa Zedde | Zendy; Elisa Giorli | Zendy; Maria Kosmidou | Zendy; Evangelos Ntais | Zendy; Lina Palaiodimou | Zendy; Panagiotis Halvatsiotis | Zendy; Tiziana Tassinari | Zendy; Valentina Saia | Zendy; Raffaele Ornello | Zendy; Simona Sacco | Zendy; Fabio Bandini | Zendy; Michelangelo Mancuso | Zendy; Giovanni Orlandi | Zendy; Elena Ferrari | Zendy; Alessandro Pezzini | Zendy; Loris Poli | Zendy; Manuel Cappellari | Zendy; Stefano Forlivesi | Zendy; Alberto Rigatelli | Zendy; Shadi Yaghi | Zendy; Erica Scher | Zendy; Jennifer Frontera | Zendy; Luca Masotti | Zendy; Elisa Grifoni | Zendy; Pietro Caliandro | Zendy; Aurelia Zauli | Zendy; Giuseppe Reale | Zendy; Simona Marcheselli | Zendy; Antonio Gasparro | Zendy; Valeria Terruso | Zendy; Valentina Arnao | Zendy; Paolo Aridon | Zendy; Azmil H. AbdulRahim | Zendy; Jesse Dawson | Zendy; Carlo Emanuele Saggese | Zendy; Francesco Palmerini | Zendy; Б. М. Доронин | Zendy; Vera Volodina | Zendy; Danilo Toni | Zendy; Angela Risitano | Zendy; Erika Schirinzi | Zendy; Massimo Del Sette | Zendy; Piergiorgio Lochner | Zendy; Serena Monaco | Zendy; Marina Mannino | Zendy; Rossana Tassi | Zendy; Francesca Guideri | Zendy; Maurizio Acampa | Zendy; Giuseppe Martini | Zendy; Enrico Maria Lotti | Zendy; Marina Padroni | Zendy; Leonardo Pantoni | Zendy; Sílvia Aguiar Rosa | Zendy; Pierluigi Bertora | Zendy; George Ntaios | Zendy; Dimitrios Sagris | Zendy; Antonio Baldi | Zendy; Cataldo D’Amore | Zendy; Nicola Mumoli | Zendy; Cesare Porta | Zendy; Licia Denti | Zendy; Alberto Chiti | Zendy; Francesco Corea | Zendy; Monica Acciarresi | Zendy; Yuriy Flomin | Zendy; Nemanja Popovic | Zendy; Georgios Tsivgoulis | Zendy

Open Access

Risk Factors for Intracerebral Hemorrhage in Patients With Atrial Fibrillation on Non–Vitamin K Antagonist Oral Anticoagulants for Stroke Prevention

Author(s) -

Maurizio Paciaroni,

Giancarlo Agnelli,

Michela Giustozzi,

Valeria Caso,

Elisabetta Toso,

Filippo Angelini,

Isabella Canavero,

Giuseppe Micieli,

Kateryna Antonenko,

Alessandro Rocco,

Marina Diomedi,

Aristeidis H. Katsanos,

Ashkan Shoamanesh,

Sotirios Giannopoulos,

Walter Ageno,

Samuela Pegoraro,

Jukka Putaala,

Daniel Strbian,

Hanne Sallinen,

Brian Mac Grory,

Karen L. Furie,

Christoph Stretz,

Michael Reznik,

Andrea Alberti,

Michele Venti,

Maria Giulia Mosconi,

Maria Cristina Vedovati,

Laura Franco,

Giorgia Zepponi,

Michele Romoli,

Andrea Zini,

Laura Brancaleoni,

Letizia Riva,

Giorgio Silvestrelli,

Alfonso Ciccone,

Marialuisa Zedde,

Elisa Giorli,

Maria Kosmidou,

Evangelos Ntais,

Lina Palaiodimou,

Panagiotis Halvatsiotis,

Tiziana Tassinari,

Valentina Saia,

Raffaele Ornello,

Simona Sacco,

Fabio Bandini,

Michelangelo Mancuso,

Giovanni Orlandi,

Elena Ferrari,

Alessandro Pezzini,

Loris Poli,

Manuel Cappellari,

Stefano Forlivesi,

Alberto Rigatelli,

Shadi Yaghi,

Erica Scher,

Jennifer Frontera,

Luca Masotti,

Elisa Grifoni,

Pietro Caliandro,

Aurelia Zauli,

Giuseppe Reale,

Simona Marcheselli,

Antonio Gasparro,

Valeria Terruso,

Valentina Arnao,

Paolo Aridon,

Azmil H. AbdulRahim,

Jesse Dawson,

Carlo Emanuele Saggese,

Francesco Palmerini,

Б. М. Доронин,

Vera Volodina,

Danilo Toni,

Angela Risitano,

Erika Schirinzi,

Massimo Del Sette,

Piergiorgio Lochner,

Serena Monaco,

Marina Mannino,

Rossana Tassi,

Francesca Guideri,

Maurizio Acampa,

Giuseppe Martini,

Enrico Maria Lotti,

Marina Padroni,

Leonardo Pantoni,

Sílvia Aguiar Rosa,

Pierluigi Bertora,

George Ntaios,

Dimitrios Sagris,

Antonio Baldi,

Cataldo D’Amore,

Nicola Mumoli,

Cesare Porta,

Licia Denti,

Alberto Chiti,

Francesco Corea,

Monica Acciarresi,

Yuriy Flomin,

Nemanja Popovic,

Georgios Tsivgoulis

Publication year - 2021

Publication title -

stroke

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 3.397

H-Index - 319

eISSN - 1524-4628

pISSN - 0039-2499

DOI - 10.1161/strokeaha.120.031827

Subject(s) - medicine , atrial fibrillation , vitamin k antagonist , intracerebral hemorrhage , stroke (engine) , antagonist , vitamin k , warfarin , cardiology , anesthesia , subarachnoid hemorrhage , receptor , mechanical engineering , engineering

Background and Purpose: Clinical trials on stroke prevention in patients with atrial fibrillation have consistently shown clinical benefit from either warfarin or non–vitamin K antagonist oral anticoagulants (NOACs). NOAC-treated patients have consistently reported to be at lower risk for intracerebral hemorrhage (ICH) than warfarin-treated patients. The aims of this prospective, multicenter, multinational, unmatched, case-control study were (1) to investigate for risk factors that could predict ICH occurring in patients with atrial fibrillation during NOAC treatment and (2) to evaluate the role of CHA2 DS2 -VASc and HAS-BLED scores in the same setting.Methods: Cases were consecutive patients with atrial fibrillation who had ICH during NOAC treatment. Controls were consecutive patients with atrial fibrillation who did not have ICH during NOAC treatment. As within the CHA2 DS2 -VASc and HAS-BLED scores there are some risk factors in common, several multivariable logistic regression models were performed to identify independent prespecified predictors for ICH events.Results: Four hundred nineteen cases (mean age, 78.8±8.1 years) and 1526 controls (mean age, 76.0±10.3 years) were included in the study. From the different models performed, independent predictors of ICH were increasing age, concomitant use of antiplatelet agents, active malignancy, high risk of fall, hyperlipidemia, low clearance of creatinine, peripheral artery disease, and white matter changes. Low doses of NOACs (given according to label or not) and congestive heart failure were inversely associated with the risk of ICH. HAS-BLED and CHA2 DS2 -VASc scores performed poorly in predicting ICH with areas under the curves of 0.496 (95% CI, 0.468–0.525) and 0.530 (95% CI, 0.500–0.560), respectively.Conclusions: Several risk factors were associated to ICH in patients treated with NOACs for stroke prevention but not HAS-BLED and CHA2 DS2 -VASc scores.

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