Abstract
Patients with mechanical heart valves are at high thrombotic risk and require warfarin. Among those developing intracranial hemorrhage, limited data are available to guide clinicians with antithrombotic reinitiation. This 13-patient case series of warfarin-associated intracranial hemorrhages found the time to reinitiate antithrombotic therapy (17 days, interquartile range 21.5 days), and changes to international normalized ratio targets were variable and neither correlated with the type, location, or etiology of bleed, nor the valve and associated thromboembolic risk. The initial presentation significantly impacted prognosis, and diligent assessment and follow-up may support positive long-term outcomes.
Keywords:
Cardiology; Hemorrhage – Cerebral; Stroke.
MeSH terms
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Aged
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Anticoagulants / therapeutic use*
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Antifibrinolytic Agents / therapeutic use
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Aortic Valve
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Aspirin / therapeutic use
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Blood Coagulation Factors / therapeutic use
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Cerebral Hemorrhage / chemically induced
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Cerebral Hemorrhage / therapy
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Female
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Heart Valve Prosthesis
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Hematoma, Subdural / chemically induced
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Hematoma, Subdural / therapy
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Humans
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International Normalized Ratio
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Intracranial Hemorrhages / chemically induced*
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Intracranial Hemorrhages / therapy
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Male
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Middle Aged
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Mitral Valve
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Plasma
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Platelet Aggregation Inhibitors / therapeutic use
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Pregnancy
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Retrospective Studies
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Subarachnoid Hemorrhage / chemically induced
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Subarachnoid Hemorrhage / therapy
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Subarachnoid Hemorrhage, Traumatic / chemically induced
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Subarachnoid Hemorrhage, Traumatic / therapy
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Thromboembolism / prevention & control*
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Vitamin K / therapeutic use
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Warfarin / therapeutic use*
Substances
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Anticoagulants
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Antifibrinolytic Agents
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Blood Coagulation Factors
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Platelet Aggregation Inhibitors
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Vitamin K
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prothrombin complex concentrates
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Warfarin
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Aspirin