Valvular & structural heart disease
Management of therapeutic anticoagulation in patients with intracerebral haemorrhage and mechanical heart valves
Main finding · Major haemorrhagic complicationsResult — go to the resultHazard ratio 10.31 95% CI 3.67–35.70Authors' conclusion
Restarting TA within less than 2 weeks after ICH in patients with MHV was associated with increased haemorrhagic complications.
Study context
- Population
- Patients with mechanical heart valves and anticoagulation-associated intracerebral haemorrhage (ICH) (RETRACE cohort)from pooled n = 2504
- Participants
- 137 patients
- Exposure
- Restarted therapeutic anticoagulation vs no therapeutic anticoagulation
- Therapeutic anticoagulation (TA)n = 66
- no-TAn = 71reference
- Outcome
- Major haemorrhagic complications
- Follow-up
- During hospital stay
Methodological detailsmulticentre, nationwide, 22 German centres, propensity-score matching
- Multicentre
- Nationwide
- 22 German centres
- Propensity-score matching
Main finding
As reported in the abstract
Hazard ratio
10.31
95% CI 3.67–35.70
P < 0.01
Events by group
TAvs no-TA
HR 10.31 (95% CI 3.67–35.70); P < 0.01
Observational data: associations, not effects.
Secondary outcomes
Thromboembolic complications · trend
P = 0.06
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Haemorrhagic complications, TA restarted until Day 13 after ICH | 7.06 (2.33–21.37) | P < 0.01 | |
| Composite haemorrhagic and thromboembolic complications, TA restarted until Day 6 | 2.51 (1.10–5.70) | P = 0.03 | |
| 0.050.21520Hazard ratio (log scale) |
Original publication
Management of therapeutic anticoagulation in patients with intracerebral haemorrhage and mechanical heart valves. Eur Heart J. Published 24 February 2018. doi:10.
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