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ESOC 2023 | Risk factors for oral anticoagulant-associated ICH

Ashkan Shoamanesh, MD, McMaster University, Hamilton, Canada, shares an overview of key risk factors for oral anticoagulant-associated intracerebral hemorrhage (OAC-ICH). Firstly, uncontrolled hypertension is a significant risk factor for OAC-ICH. According to the INTERSTROKE case-control study of potentially modifiable risk factors associated with acute stroke, a history of hypertension is responsible for almost 50% of the population attributable risk of ICH. Lack of regular physical activity, unhealthy diet, elevated psychosocial stress, smoking, and alcohol consumption were also shown to increase OAC-ICH risk. Studies also indicate that the use of vitamin K antagonists (VKAs) increases the risk of OAC-ICH, when compared to newer direct oral anticoagulants (DOACs), which have replaced VKAs as the gold standard for treatment of atrial fibrillation. Dr Shoamanesh also comments on recent evidence suggesting potential harm associated with the concomitant long-term use of antiplatelet treatment in patients receiving anticoagulation therapy. This interview took place during the European Stroke Organisation Conference (ESOC) in Munich, Germany.

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