The rate of anticoagulant-associated intracerebral hemorrhage has increased dramatically since 1988, according to an observational study published in the journal Neurology. Researchers identified all patients hospitalized with first-ever intracerebral hemorrhage (ICH) in the 5-county Greater Cincinnati, Ohio/Northern Kentucky area during 3 unique time periods.
"The downward trend for warfarin counting units per AAICH over time suggests that rates of AAICH increased more rapidly than the distribution of warfarin. This may be due to a disproportionate increase in warfarin use among elderly persons who have higher bleeding risks," the authors stated.
The authors stated that warfarin should still be considered to prevent ischemic stroke in appropriately selected patients with atrial fibrillation, as the treatment is highly effective and offers a favorable anticoagulation risk:benefit ratio in many patients. "Our findings should not discourage warfarin use when appropriate, but rather spur research into safer alternatives to warfarin, improved risk stratification for elderly patients, and better treatments for patients with hemorrhagic complications," the authors stated.
SOURCE Flaherty ML, Kissela B, Woo D, et al. The increasing incidence of anticoagulant-associated intra-cerebral hemorrhage. Neurology. 2007;68:116–121.