Anticoagulation after Spontaneous Intraparenchymal Hemorrhage in Patients with Mechanical Heart Valves and Concomitant Atrial Fibrillation

Aim Patients with mechanical heart valves and coexisting atrial fibrillation (AFib-MHV) who suffer an intraparenchymal hemorrhage (IPH, defined as bleeding solely within the brain parenchyma and/or ventricle) are at a high risk of thromboembolism without anticoagulation. Data are lacking regarding t...

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Autores principales:	Jennifer H. Kang, Michael L. James, Allison Gibson, Ovais Inamullah, Gary Clay Sherrill, Michael W. Lutz, Christa B. Swisher
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical and Scientific Publishers Pvt. Ltd. 2021
Materias:	anticoagulation intracerebral hemorrhage mechanical heart valve atrial fibrillation Anesthesiology RD78.3-87.3
Acceso en línea:	https://doaj.org/article/316dd5bdaf3c47da93131d74d0a8fcbf
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spelling	oai:doaj.org-article:316dd5bdaf3c47da93131d74d0a8fcbf2021-12-02T23:53:13ZAnticoagulation after Spontaneous Intraparenchymal Hemorrhage in Patients with Mechanical Heart Valves and Concomitant Atrial Fibrillation2348-05482348-926X10.1055/s-0041-1735653https://doaj.org/article/316dd5bdaf3c47da93131d74d0a8fcbf2021-09-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1735653https://doaj.org/toc/2348-0548https://doaj.org/toc/2348-926XAim Patients with mechanical heart valves and coexisting atrial fibrillation (AFib-MHV) who suffer an intraparenchymal hemorrhage (IPH, defined as bleeding solely within the brain parenchyma and/or ventricle) are at a high risk of thromboembolism without anticoagulation. Data are lacking regarding the safety of early re-initiation of anticoagulation in these patients. Patients and Methods We performed a descriptive, single-institution retrospective analysis of patients with AFib-MHV who suffered a non-traumatic, supratentorial IPH between July 2013 and June 2017. We analyzed the patients and IPH characteristics, anticoagulation and antiplatelet use, the occurrence of thrombotic and hemorrhage complications, and discharge disposition. We described the timing of initiation of anticoagulation and outcomes after IPH while in-patient. Results Six patients with AFib-MHV suffered a spontaneous IPH. Four were initiated on anticoagulation prior to discharge, of whom two were initiated within 3 days post-hemorrhage. These patients suffered no bleeding complications and were discharged home with a modified Rankin Scale of 1. Conclusion Patients with AFib-MHV who suffer a spontaneous IPH are a rare population to study. Further studies to guide the management of restarting anticoagulation in this select population are warranted.Jennifer H. KangMichael L. JamesAllison GibsonOvais InamullahGary Clay SherrillMichael W. LutzChrista B. SwisherThieme Medical and Scientific Publishers Pvt. Ltd.articleanticoagulationintracerebral hemorrhagemechanical heart valveatrial fibrillationAnesthesiologyRD78.3-87.3ENJournal of Neuroanaesthesiology and Critical Care, Vol 08, Iss 03, Pp 203-207 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	anticoagulation intracerebral hemorrhage mechanical heart valve atrial fibrillation Anesthesiology RD78.3-87.3
spellingShingle	anticoagulation intracerebral hemorrhage mechanical heart valve atrial fibrillation Anesthesiology RD78.3-87.3 Jennifer H. Kang Michael L. James Allison Gibson Ovais Inamullah Gary Clay Sherrill Michael W. Lutz Christa B. Swisher Anticoagulation after Spontaneous Intraparenchymal Hemorrhage in Patients with Mechanical Heart Valves and Concomitant Atrial Fibrillation
description	Aim Patients with mechanical heart valves and coexisting atrial fibrillation (AFib-MHV) who suffer an intraparenchymal hemorrhage (IPH, defined as bleeding solely within the brain parenchyma and/or ventricle) are at a high risk of thromboembolism without anticoagulation. Data are lacking regarding the safety of early re-initiation of anticoagulation in these patients. Patients and Methods We performed a descriptive, single-institution retrospective analysis of patients with AFib-MHV who suffered a non-traumatic, supratentorial IPH between July 2013 and June 2017. We analyzed the patients and IPH characteristics, anticoagulation and antiplatelet use, the occurrence of thrombotic and hemorrhage complications, and discharge disposition. We described the timing of initiation of anticoagulation and outcomes after IPH while in-patient. Results Six patients with AFib-MHV suffered a spontaneous IPH. Four were initiated on anticoagulation prior to discharge, of whom two were initiated within 3 days post-hemorrhage. These patients suffered no bleeding complications and were discharged home with a modified Rankin Scale of 1. Conclusion Patients with AFib-MHV who suffer a spontaneous IPH are a rare population to study. Further studies to guide the management of restarting anticoagulation in this select population are warranted.
format	article
author	Jennifer H. Kang Michael L. James Allison Gibson Ovais Inamullah Gary Clay Sherrill Michael W. Lutz Christa B. Swisher
author_facet	Jennifer H. Kang Michael L. James Allison Gibson Ovais Inamullah Gary Clay Sherrill Michael W. Lutz Christa B. Swisher
author_sort	Jennifer H. Kang
title	Anticoagulation after Spontaneous Intraparenchymal Hemorrhage in Patients with Mechanical Heart Valves and Concomitant Atrial Fibrillation
title_short	Anticoagulation after Spontaneous Intraparenchymal Hemorrhage in Patients with Mechanical Heart Valves and Concomitant Atrial Fibrillation
title_full	Anticoagulation after Spontaneous Intraparenchymal Hemorrhage in Patients with Mechanical Heart Valves and Concomitant Atrial Fibrillation
title_fullStr	Anticoagulation after Spontaneous Intraparenchymal Hemorrhage in Patients with Mechanical Heart Valves and Concomitant Atrial Fibrillation
title_full_unstemmed	Anticoagulation after Spontaneous Intraparenchymal Hemorrhage in Patients with Mechanical Heart Valves and Concomitant Atrial Fibrillation
title_sort	anticoagulation after spontaneous intraparenchymal hemorrhage in patients with mechanical heart valves and concomitant atrial fibrillation
publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
publishDate	2021
url	https://doaj.org/article/316dd5bdaf3c47da93131d74d0a8fcbf
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Anticoagulation after Spontaneous Intraparenchymal Hemorrhage in Patients with Mechanical Heart Valves and Concomitant Atrial Fibrillation

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