Clinical Review

Stroke Risk

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RISK OF THROMBOEMBOLISM AFTER ICH: IS RESUMPTION OF WARFARIN THERAPY SAFE?
Witt DM, Clark NP, Martinez K, et al. Risk of thromboembolism, recurrent hemorrhage, and death after warfarin therapy interruption for intracranial hemorrhage. Thromb Res. 2015;136(5):1040-1044.

Patients resuming warfarin therapy following warfarin-associated intracranial hemorrhage (ICH) appeared not to be at increased risk for recurrent ICH but instead tended toward reduced thrombosis and all-cause mortality in a cohort study of 160 individuals discharged from the hospital following warfarin-related index of ICH. In the study, 33.8% of patients resumed warfarin therapy and 66.2% did not. Researchers found:
• Recurrent ICH occurred in a numerically greater, but statistically nonsignificant, proportion of patients who did not resume warfarin therapy (7.6% vs 3.7%).
• Patients who did not resume warfarin had three-fold higher (12.3% vs 3.7%) and approximately two-fold higher (31.3% vs. 18.5%) rates of thrombosis and all-cause mortality during follow-up.

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