Letter by Chan and Siu Regarding Article, “Use of Oral Anticoagulants for Stroke Prevention in Patients With Atrial Fibrillation Who Have a History of Intracranial Hemorrhage”
This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
To the Editor:
We congratulate Chao and colleagues1 on their recent article in Circulation on the use of oral anticoagulants to prevent stroke in patients with atrial fibrillation with a history of intracranial hemorrhage (ICH). The article provides imperative information that may facilitate the decision on antithrombotic strategy in this challenging clinical scenario. However, some aspects give cause for concern.
First, not all ICHs share the same recurrence risk. A diagnosis of ICH encompasses heterogeneous subtypes that include intracerebral hemorrhage, subarachnoid hemorrhage, and subdural hematoma. The recurrence risk of subdural hematoma is typically 2 to 3 times that of intracerebral hemorrhage. Even among intracerebral hemorrhages, lobar hemorrhage has a …