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Anticoagulation after Spontaneous Intraparenchymal Hemorrhage in Patients with Mechanical Heart Valves and Concomitant Atrial Fibrillation

Publication ,  Journal Article
Kang, JH; James, ML; Gibson, A; Inamullah, O; Sherrill, GC; Lutz, MW; Swisher, CB
Published in: Journal of Neuroanaesthesiology and Critical Care
September 1, 2021

Aim Patients with mechanical heart valves and coexisting atrial fibrillation (AFib-MHV) who suffer an intraparenchymal hemorrhage (IPH, defined as bleeding solely within the brain parenchyma and/or ventricle) are at a high risk of thromboembolism without anticoagulation. Data are lacking regarding the safety of early re-initiation of anticoagulation in these patients. Patients and Methods We performed a descriptive, single-institution retrospective analysis of patients with AFib-MHV who suffered a non-traumatic, supratentorial IPH between July 2013 and June 2017. We analyzed the patients and IPH characteristics, anticoagulation and antiplatelet use, the occurrence of thrombotic and hemorrhage complications, and discharge disposition. We described the timing of initiation of anticoagulation and outcomes after IPH while in-patient. Results Six patients with AFib-MHV suffered a spontaneous IPH. Four were initiated on anticoagulation prior to discharge, of whom two were initiated within 3 days post-hemorrhage. These patients suffered no bleeding complications and were discharged home with a modified Rankin Scale of 1. Conclusion Patients with AFib-MHV who suffer a spontaneous IPH are a rare population to study. Further studies to guide the management of restarting anticoagulation in this select population are warranted.

Duke Scholars

Published In

Journal of Neuroanaesthesiology and Critical Care

DOI

EISSN

2348-0548

Publication Date

September 1, 2021

Volume

8

Issue

3

Start / End Page

203 / 207
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kang, J. H., James, M. L., Gibson, A., Inamullah, O., Sherrill, G. C., Lutz, M. W., & Swisher, C. B. (2021). Anticoagulation after Spontaneous Intraparenchymal Hemorrhage in Patients with Mechanical Heart Valves and Concomitant Atrial Fibrillation. Journal of Neuroanaesthesiology and Critical Care, 8(3), 203–207. https://doi.org/10.1055/s-0041-1735653
Kang, J. H., M. L. James, A. Gibson, O. Inamullah, G. C. Sherrill, M. W. Lutz, and C. B. Swisher. “Anticoagulation after Spontaneous Intraparenchymal Hemorrhage in Patients with Mechanical Heart Valves and Concomitant Atrial Fibrillation.” Journal of Neuroanaesthesiology and Critical Care 8, no. 3 (September 1, 2021): 203–7. https://doi.org/10.1055/s-0041-1735653.
Kang JH, James ML, Gibson A, Inamullah O, Sherrill GC, Lutz MW, et al. Anticoagulation after Spontaneous Intraparenchymal Hemorrhage in Patients with Mechanical Heart Valves and Concomitant Atrial Fibrillation. Journal of Neuroanaesthesiology and Critical Care. 2021 Sep 1;8(3):203–7.
Kang, J. H., et al. “Anticoagulation after Spontaneous Intraparenchymal Hemorrhage in Patients with Mechanical Heart Valves and Concomitant Atrial Fibrillation.” Journal of Neuroanaesthesiology and Critical Care, vol. 8, no. 3, Sept. 2021, pp. 203–07. Scopus, doi:10.1055/s-0041-1735653.
Kang JH, James ML, Gibson A, Inamullah O, Sherrill GC, Lutz MW, Swisher CB. Anticoagulation after Spontaneous Intraparenchymal Hemorrhage in Patients with Mechanical Heart Valves and Concomitant Atrial Fibrillation. Journal of Neuroanaesthesiology and Critical Care. 2021 Sep 1;8(3):203–207.
Journal cover image

Published In

Journal of Neuroanaesthesiology and Critical Care

DOI

EISSN

2348-0548

Publication Date

September 1, 2021

Volume

8

Issue

3

Start / End Page

203 / 207