Advances in Anticoagulant Resumption after Intracerebral Hemorrhage

doi:10.3969/j.issn.1673-5765.2020.01.007

Abstract

Abstract:

Anticoagulation is currently recommended and commonly used in patients with atrial fibrillation and/or mechanical prosthetic heart valves to prevent thromboembolism events, especially stroke. However, the decision-making about whether and when to resume anticoagulant after intracerebral hemorrhage (ICH) is still an unsolved problem due to lacking randomized controlled trials. Several large-scale observational studies and meta analysis showed that anticoagulant resumption after ICH decreased thromboembolic complications without increasing hemorrhagic complications. Given the lack of high-quality evidence, clinicians should carefully balance the risk of thromboembolism and recurrent ICH in individual patients.

Key words: Intracerebral Hemorrhage; Anticoagulation; Warfarin; Non-vitamin K oralb anticoagulant

摘要：

抗凝治疗已广泛用于心房颤动和（或）机械性心脏瓣膜患者以预防血栓栓塞事件，尤其是预防缺血性卒中的发生。然而，脑出血后是否应继续抗凝治疗及何时重启抗凝治疗仍是临床未解的难题。虽然目前已有数项大样本观察性研究和Meta分析提示脑出血后重启抗凝治疗可降低血栓栓塞并发症且没有明显增加出血并发症，但是尚缺乏随机对照试验进一步证实。因此，目前在缺乏指导临床决策的高质量临床研究证据的情况下，临床实践中应权衡患者血栓栓塞事件风险和脑出血复发风险进行个体化处理。

关键词: 脑出血; 抗凝; 华法林; 非维生素K口服抗凝剂

WU Jiong-Xing, WANG De-Ren. Advances in Anticoagulant Resumption after Intracerebral Hemorrhage[J]. Chinese Journal of Stroke, 2020, 15(01): 46-50.

吴炯星，王德任. 脑出血后重启抗凝治疗的研究进展[J]. 中国卒中杂志, 2020, 15(01): 46-50.

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