@article{2987372,
    title = "Risk Factors for Intracerebral Hemorrhage in Patients with Atrial Fibrillation on Non-Vitamin K Antagonist Oral Anticoagulants for Stroke Prevention",
    author = "Paciaroni, M. and Agnelli, G. and Giustozzi, M. and Caso, V. and Toso, E. and Angelini, F. and Canavero, I. and Micieli, G. and Antonenko, K. and Rocco, A. and Diomedi, M. and Katsanos, A.H. and Shoamanesh, A. and Giannopoulos, S. and Ageno, W. and Pegoraro, S. and Putaala, J. and Strbian, D. and Sallinen, H. and Mac Grory, B.C. and Furie, K.L. and Stretz, C. and Reznik, M.E. and Alberti, A. and Venti, M. and Mosconi, M.G. and Vedovati, M.C. and Franco, L. and Zepponi, G. and Romoli, M. and Zini, A. and Brancaleoni, L. and Riva, L. and Silvestrelli, G. and Ciccone, A. and Zedde, M.L. and Giorli, E. and Kosmidou, M. and Ntais, E. and Palaiodimou, L. and Halvatsiotis, P. and Tassinari, T. and Saia, V. and Ornello, R. and Sacco, S. and Bandini, F. and Mancuso, M. and Orlandi, G. and Ferrari, E. and Pezzini, A. and Poli, L. and Cappellari, M. and Forlivesi, S. and Rigatelli, A. and Yaghi, S. and Scher, E. and Frontera, J.A. and Masotti, L. and Grifoni, E. and Caliandro, P. and Zauli, A. and Reale, G. and Marcheselli, S. and Gasparro, A. and Terruso, V. and Arnao, V. and Aridon, P. and Abdul-Rahim, A.H. and Dawson, J. and Saggese, C.E. and Palmerini, F. and Doronin, B. and Volodina, V. and Toni, D. and Risitano, A. and Schirinzi, E. and Del Sette, M. and Lochner, P. and Monaco, S. and Mannino, M. and Tassi, R. and Guideri, F. and Acampa, M. and Martini, G. and Lotti, E.M. and Padroni, M. and Pantoni, L. and Rosa, S. and Bertora, P. and Ntaios, G. and Sagris, D. and Baldi, A. and D'Amore, C. and Mumoli, N. and Porta, C. and Denti, L. and Chiti, A. and Corea, F. and Acciarresi, M. and Flomin, Y. and Popovic, N. and Tsivgoulis, G.",
    journal = "ISRN Stroke",
    year = "2021",
    pages = "1450-1454",
    publisher = "Lippincott Williams and Wilkins",
    issn = "2090-9454",
    doi = "10.1161/STROKEAHA.120.031827",
    keywords = "antithrombin, aged;  atrial fibrillation;  brain hemorrhage;  case control study;  cerebrovascular accident;  clinical trial;  complication;  female;  human;  male;  middle aged;  multicenter study;  oral drug administration;  prospective study;  risk factor;  very elderly, Administration, Oral;  Aged;  Aged, 80 and over;  Antithrombins;  Atrial Fibrillation;  Case-Control Studies;  Cerebral Hemorrhage;  Female;  Humans;  Male;  Middle Aged;  Prospective Studies;  Risk Factors;  Stroke",
    abstract = "Background and Purpose: Clinical trials on stroke prevention in patients with atrial fibrillation have consistently shown clinical benefit from either warfarin or non-vitamin K antagonist oral anticoagulants (NOACs). NOAC-treated patients have consistently reported to be at lower risk for intracerebral hemorrhage (ICH) than warfarin-treated patients. The aims of this prospective, multicenter, multinational, unmatched, case-control study were (1) to investigate for risk factors that could predict ICH occurring in patients with atrial fibrillation during NOAC treatment and (2) to evaluate the role of CHA2DS2-VASc and HAS-BLED scores in the same setting. Methods: Cases were consecutive patients with atrial fibrillation who had ICH during NOAC treatment. Controls were consecutive patients with atrial fibrillation who did not have ICH during NOAC treatment. As within the CHA2DS2-VASc and HAS-BLED scores there are some risk factors in common, several multivariable logistic regression models were performed to identify independent prespecified predictors for ICH events. Results: Four hundred nineteen cases (mean age, 78.8±8.1 years) and 1526 controls (mean age, 76.0±10.3 years) were included in the study. From the different models performed, independent predictors of ICH were increasing age, concomitant use of antiplatelet agents, active malignancy, high risk of fall, hyperlipidemia, low clearance of creatinine, peripheral artery disease, and white matter changes. Low doses of NOACs (given according to label or not) and congestive heart failure were inversely associated with the risk of ICH. HAS-BLED and CHA2DS2-VASc scores performed poorly in predicting ICH with areas under the curves of 0.496 (95% CI, 0.468-0.525) and 0.530 (95% CI, 0.500-0.560), respectively. Conclusions: Several risk factors were associated to ICH in patients treated with NOACs for stroke prevention but not HAS-BLED and CHA2DS2-VASc scores. © 2021 Lippincott Williams and Wilkins. All rights reserved."
}