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Current Cardiology Reports
Erschienen in: Current Cardiology Reports 5/2014

01.05.2014 | New Therapies for Cardiovascular Disease (KW Mahaffey, Section Editor)

Intracranial Hemorrhage and Novel Anticoagulants for Atrial Fibrillation: What Have We Learned?

verfasst von: Graeme J. Hankey

Erschienen in: Current Cardiology Reports | Ausgabe 5/2014

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Abstract

Intracranial hemorrhage (ICH) affects 0.2-0.5 % of atrial fibrillation (AF) patients taking a novel oral anticoagulant (NOAC) each year. About two thirds of ICHs are intracerebral and one quarter subdural. The 30-day case fatality of NOAC-associated ICH was similar to that of warfarin-associated ICH in two trials. Consistent predictors of ICH are increasing age, a history of prior stroke or TIA, and concomitant use of an antiplatelet drug. Compared to warfarin, the NOACs significantly reduce the risk of ICH by half (risk ratio = 0.44; 95 % CI: 0.37 to 0.51). Compared to aspirin, apixaban has a similar risk of ICH (risk ratio = 0.84; 95 % CI, 0.38 to 1.87). Current treatments for NOAC-associated ICH include nonactivated and activated prothrombin complex concentrate, which reverse the anticoagulant effects of the NOACs, but their effects on bleeding and patient outcome are not known. Future treatments for NOAC-associated ICH promise to include specific antidotes to dabigatran (e.g., aDabi-Fab, PER977) and factor Xa inhibitors (e.g., r-Antidote PRT064445, PER977).
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Metadaten
Titel
Intracranial Hemorrhage and Novel Anticoagulants for Atrial Fibrillation: What Have We Learned?
verfasst von
Graeme J. Hankey
Publikationsdatum
01.05.2014
Verlag
Springer US
Erschienen in
Current Cardiology Reports / Ausgabe 5/2014
Print ISSN: 1523-3782
Elektronische ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-014-0480-9

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