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WSC 2022 | Restarting anticoagulation after ICH in patients with atrial fibrillation

For patients with atrial fibrillation (AF) who survive intracerebral hemorrhage (ICH), the decision to restart oral anticoagulation (OAC) has often presented a clinical dilemma. This is because of the high risk of thrombotic events. OAC can reduce the risk of thrombotic events, however it may increase the risk of recurrent ICH. Hanne Christensen, MD, PhD, MSci, University of Copenhagen, Copenhagen, Denmark, outlines recent clinical trials such as the RESTART pilot trial (ISRCTN71907627) and the ongoing ENRICH-AF trial (NCT03950076) that are beginning to suggest that the benefits may outweigh the risks when using OAC in these cases. There is, however, a need for further clinical trials to provide enough data to make a clinical decision on this and to better understand which patients may be at higher risk of recurrent ICH or thrombotic events. This interview took place at the World Stroke Congress 2022 in Singapore.

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Hanne Christensen is national lead for the ANNEXA-i trial and has received speaker’s honoraria from BMS and Bayer.