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Antithrombotic treatment after Intracerebral Haemorrhage

Research project The aims of this project are to describe the prescription pattern of antithrombotic therapy in intracerebral haemorrhage survivors in Swedish clinical practice, and the effect of antithrombotic treatment in patients with concurring atrial fibrillation.

Patients with intracerebral haemorrhages (ICH) often have cogent indications for antithrombotic therapy (AT) such as atrial fibrillation (AF). This represents a therapeutic dilemma as antiplatelets (AP) and anticoagulants (AC) are often perceived as contraindicated following ICH. International guidelines give varying recommendations. We will use the Swedish stroke register (Riksstroke), other national health data registers at the National Board of Health and Welfare to describe the prescription pattern of AT therapy in ICH survivors in Swedish clinical practice, and the effect of antithrombotic treatment in ICH survivors with concurring AF.

Head of project

Project overview

Project period

2015-01-01 2018-12-31

Funding

Strokeforskningen i Norrland Insamlingsstiftelse, 2015: SEK 60,000

Research subject

Statistics

Project description

Patients with intracerebral haemorrhages (ICH) often have cogent indications for antithrombotic therapy (AT) such as atrial fibrillation. This represents a therapeutic dilemma as antiplatelets (AP) and anticoagulants (AC) are often perceived as contraindicated following ICH.

International guidelines give varying recommendations. American guidelines advise against resumption of oral AC after warfarin-associated ICH2 while European guidelines find it possible to resume AC treatment, if proceeding with caution (ESO 2006). The lack of consensus is probably attributable to the sparse scientific background material. Overall, it seems as a limited number of patients with resumption of AC-treatment following ICH have been reported in the literature. The largest published study regarding AP following ICH includes 120 patients, while the still unpublished study from Norrbotten includes 203 patients. There is a clear requirement for further high quality observational data on the clinical impact of AT in the patient group of ICH survivors.

We will use the Swedish stroke register (Riksstroke), other national health data registers and the prescribed drug register at the National Board of Health and Welfare to describe the prescription pattern of antithrombotic therapy in ICH survivors in Swedish clinical practice, and the effect of antithrombotic treatment in ICH survivors with concurring AF.