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Current Atherosclerosis Reports

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Open Access 01-07-2018 | Cardiovascular Disease and Stroke (S. Prabhakaran, Section Editor)

Anticoagulation Resumption After Intracerebral Hemorrhage

Authors: Yan-guang Li, Gregory Y. H. Lip

Published in: Current Atherosclerosis Reports | Issue 7/2018

Abstract

Purpose of review

Decision-making on resuming oral anticoagulant (OAC) after intracerebral hemorrhage (ICH) evokes significant debate among clinicians. Such patients have been excluded from randomized clinical trials. This review article provides a comprehensive summary of the evidence on anticoagulation resumption after ICH.

Recent findings

OAC resumption does not increase the risk of recurrent ICH and can also reduce the risk of all-cause mortality. OAC cessation exposes patients to a significantly higher risk of thromboembolism, which could be reduced by resumption. The optimal timing of anticoagulation resumption after ICH is still unknown. Both early (< 2 weeks) and late (> 4 weeks) resumption should be reached only after very careful assessment of risks for ICH recurrence and thromboembolism. The introduction of new oral anticoagulants and other interventions, such as left atrial appendage closure, has provided some patients with more alternatives.

Summary

Given the lack of high-quality evidence to guide clinical decision-making, clinicians must carefully balance the risks of thromboembolism and recurrent ICH in individual patients. We propose a management approach which would facilitate the decision-making process on whether anticoagulation is appropriate, as well as when and how to restart anticoagulation after ICH.

• Ottosen TP, Grijota M, Hansen ML, et al. Use of antithrombotic therapy and long-term clinical outcome among patients surviving intracerebral hemorrhage. Stroke. 2016;47(7):1837–43. A good population-based cohort study illustrated the long-term benefits of anticoagulation among patients surviving intracerebral hemorrhage. CrossRefPubMed

Purrucker JC, Haas K, Rizos T, Khan S, Wolf M, Hennerici MG, et al. Early clinical and radiological course, management, and outcome of intracerebral hemorrhage related to new oral anticoagulants. JAMA Neurol. 2016;73(2):169–77.CrossRefPubMed

Lansberg MG, O'Donnell MJ, Khatri P, Lang ES, Nguyen-Huynh MN, Schwartz NE, et al. Antithrombotic and thrombolytic therapy for ischemic stroke: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e601S–36S.CrossRefPubMedPubMedCentral

Liotta EM, Prabhakaran S. Warfarin-associated intracerebral hemorrhage is increasing in prevalence in the United States. J Stroke Cerebrovasc Dis. 2013;22(7):1151–5.CrossRefPubMed

Kittelson JM, Steg PG, Halperin JL, Goldenberg NA, Schulman S, Spyropoulos AC, et al. Bivariate evaluation of thromboembolism and bleeding in clinical trials of anticoagulants in patients with atrial fibrillation. Thromb Haemost. 2016;116(3):544–53.PubMed

Zazulia A. Antiplatelet and anticoagulant therapy after intracerebral hemorrhage. Neurol Clin. 2015;33(2):329–45.CrossRefPubMed

Lip G, Freedman B, De Caterina R, Potpara TS. Stroke prevention in atrial fibrillation: past, present and future. Comparing the guidelines and practical decision-making. Thromb Haemost. 2017;117(7):1230–9.CrossRefPubMed

Paciaroni M, Agnelli G, Ageno W, Caso V. Timing of anticoagulation therapy in patients with acute ischaemic stroke and atrial fibrillation. Thromb Haemost. 2016;116(3):410–6.PubMed

Esteve-Pastor MA, Rivera-Caravaca JM, Shantsila A, Roldan V, Lip GYH, Marin F. Assessing bleeding risk in atrial fibrillation patients: comparing a bleeding risk score based only on modifiable bleeding risk factors against the HAS-BLED score. The AMADEUS Trial. Thromb Haemost. 2017;117(12):2261–6.CrossRefPubMed

10.

Guo Y, Zhu H, Chen Y, Lip GYH. Comparing bleeding risk assessment focused on modifiable risk factors only versus validated bleeding risk scores in atrial fibrillation. Am J Med. 2018;131(2):185–92.CrossRefPubMed

11.

Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Europace: European pacing, arrhythmias, and cardiac electrophysiology: journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2016. 2016;18(11):1609–78.CrossRef

12.

Giakoumettis D, Alexiou GA, Vrachatis DA, Themistoklis K, Stathis P, Vavuranakis M, et al. Antithrombotic treatment management in patients with intracerebral hemorrhage: reversal and restart. Curr Pharm Des. 2017;23(9):1392–405.CrossRefPubMed

13.

Poli D, Antonucci E, Dentali F, Erba N, Testa S, Tiraferri E, et al. Recurrence of ICH after resumption of anticoagulation with VK antagonists: CHIRONE study. Neurology. 2014;82(12):1020–6.CrossRefPubMed

14.

Witt DM, Clark NP, Martinez K, Schroeder A, Garcia D, Crowther MA, et al. Risk of thromboembolism, recurrent hemorrhage, and death after warfarin therapy interruption for intracranial hemorrhage. Thromb Res. 2015;136(5):1040–4.CrossRefPubMed

15.

•• Nielsen PB, Larsen TB, Skjoth F, Gorst-Rasmussen A, Rasmussen LH, Lip GY. Restarting anticoagulant treatment after intracranial hemorrhage in patients with atrial fibrillation and the impact on recurrent stroke, mortality, and bleeding: a nationwide cohort study. Circulation. 2015;132(6):517–25. A very good nationwide registry study demonstrated the benefit of anticoagulation reinitiation in patients with atrial fibrillation and intracranial hemorrhage. CrossRefPubMed

16.

Kuramatsu JB, Gerner ST, Schellinger PD, Glahn J, Endres M, Sobesky J, et al. Anticoagulant reversal, blood pressure levels, and anticoagulant resumption in patients with anticoagulation-related intracerebral hemorrhage. JAMA. 2015;313(8):824–36.CrossRefPubMed

17.

•• Nielsen PB, Larsen TB, Skjoth F, Lip GY. Outcomes associated with resuming warfarin treatment after hemorrhagic stroke or traumatic intracranial hemorrhage in patients with atrial fibrillation. JAMA Intern Med. 2017;177(4):563–70. A very good long-term follow-up and nationwide observational cohort study showed the benefits of warfarin resumption among patients with AF and spontaneous hemorrhagic stroke. CrossRefPubMedPubMedCentral

18.

Murthy SB, Gupta A, Merkler AE, Navi BB, Mandava P, Iadecola C, et al. Restarting anticoagulant therapy after intracranial hemorrhage: a systematic review and meta-analysis. Stroke. 2017;48(6):1594–600.CrossRefPubMedPubMedCentral

19.

Poli L, Grassi M, Zedde M, Marcheselli S, Silvestrelli G, Sessa M, et al. Anticoagulants resumption after warfarin-related intracerebral Haemorrhage: the multicenter study on cerebral hemorrhage in Italy (MUCH-Italy). Thromb Haemost. 2018;

20.

Park YA, Uhm JS, Pak HN, Lee MH, Joung B. Anticoagulation therapy in atrial fibrillation after intracranial hemorrhage. Heart rhythm: the official journal of the heart rhythm. Society. 2016;13(9):1794–802.

21.

Pennlert J, Asplund K, Carlberg B, Wiklund PG, Wisten A, Åsberg S, et al. Antithrombotic treatment following intracerebral hemorrhage in patients with and without atrial fibrillation. Stroke. 2015;46(8):2094–9.CrossRefPubMed

22.

Yung D, Kapral MK, Asllani E, Fang J, Lee DS, Investigators of the Registry of the Canadian Stroke N. Reinitiation of anticoagulation after warfarin-associated intracranial hemorrhage and mortality risk: the best practice for reinitiating anticoagulation therapy after intracranial bleeding (BRAIN) study. Can J Cardiol. 2012;28(1):33–9.CrossRefPubMed

23.

Paciaroni M, Agnelli G. Should oral anticoagulants be restarted after warfarin-associated cerebral haemorrhage in patients with atrial fibrillation? Thromb Haemost. 2014;111(1):14–8.CrossRefPubMed

24.

Charidimou A, Karayiannis C, Song TJ, Orken DN, Thijs V, Lemmens R, et al. Brain microbleeds, anticoagulation, and hemorrhage risk: meta-analysis in stroke patients with AF. Neurology. 2017;89(23):2317–26.CrossRefPubMed

25.

DeSimone CV, Graff-Radford J, El-Harasis MA, Rabinstein AA, Asirvatham SJ, Holmes DR Jr. Cerebral amyloid angiopathy: diagnosis, clinical implications, and management strategies in atrial fibrillation. J Am Coll Cardiol. 2017;70(9):1173–82.CrossRefPubMed

26.

Poon MT, Fonville AF, Al-Shahi Salman R. Long-term prognosis after intracerebral haemorrhage: systematic review and meta-analysis. J Neurol Neurosurg Psychiatry. 2014;85(6):660–7.CrossRefPubMed

27.

Ren Y, Zheng J, Liu X, Li H, You C. Risk factors of rehemorrhage in postoperative patients with spontaneous intracerebral hemorrhage : a case-control study. J Korean Neurosurg Soc. 2018;61(1):35–41.CrossRefPubMed

28.

Tseng CH, Muo CH, Hsu CY, Kao CH. Increased risk of intracerebral hemorrhage among patients with hepatitis C virus infection. Medicine. 2015;94(46):e2132.CrossRefPubMedPubMedCentral

29.

Sturgeon JD, Folsom AR, Longstreth WT Jr, Shahar E, Rosamond WD, Cushman M. Risk factors for intracerebral hemorrhage in a pooled prospective study. Stroke. 2007;38(10):2718–25.CrossRefPubMed

30.

van Etten ES, Auriel E, Haley KE, Ayres AM, Vashkevich A, Schwab KM, et al. Incidence of symptomatic hemorrhage in patients with lobar microbleeds. Stroke. 2014;45(8):2280–5.CrossRefPubMedPubMedCentral

31.

Kongbunkiat K, Wilson D, Kasemsap N, Tiamkao S, Jichi F, Palumbo V, et al. Leukoaraiosis, intracerebral hemorrhage, and functional outcome after acute stroke thrombolysis. Neurology. 2017;88(7):638–45.CrossRefPubMedPubMedCentral

32.

Yamashita T, Koretsune Y, Yang Y, et al. Edoxaban vs. warfarin in East Asian patients with atrial fibrillation—an ENGAGE AF-TIMI 48 subanalysis. Circ J: Off J Jpn Circ Society. 2016;80(4):860–9.CrossRef

33.

Goto S, Zhu J, Liu L, Oh BH, Wojdyla DM, Aylward P, et al. Efficacy and safety of apixaban compared with warfarin for stroke prevention in patients with atrial fibrillation from East Asia: a subanalysis of the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) Trial. Am Heart J. 2014;168(3):303–9.CrossRefPubMed

34.

Wong KS, Hu DY, Oomman A, et al. Rivaroxaban for stroke prevention in East Asian patients from the ROCKET AF trial. Stroke. 2014;45(6):1739–47.CrossRefPubMed

35.

Hori M, Connolly SJ, Zhu J, Liu LS, Lau CP, Pais P, et al. Dabigatran versus warfarin: effects on ischemic and hemorrhagic strokes and bleeding in Asians and non-Asians with atrial fibrillation. Stroke. 2013;44(7):1891–6.CrossRefPubMed

36.

Chao TF, Lip GYH, Lin YJ, Chang SL, Lo LW, Hu YF, et al. Major bleeding and intracranial hemorrhage risk prediction in patients with atrial fibrillation: attention to modifiable bleeding risk factors or use of a bleeding risk stratification score? A nationwide cohort study. Int J Cardiol. 2018;254:157–61.CrossRefPubMed

37.

Beyth RJ, Quinn LM, Landefeld CS. Prospective evaluation of an index for predicting the risk of major bleeding in outpatients treated with warfarin. Am J Med. 1998;105(2):91–9.CrossRefPubMed

38.

Gage BF, Yan Y, Milligan PE, Waterman AD, Culverhouse R, Rich MW, et al. Clinical classification schemes for predicting hemorrhage: results from the National Registry of Atrial Fibrillation (NRAF). Am Heart J. 2006;151(3):713–9.CrossRefPubMed

39.

Shireman TI, Mahnken JD, Howard PA, Kresowik TF, Hou Q, Ellerbeck EF. Development of a contemporary bleeding risk model for elderly warfarin recipients. Chest. 2006;130(5):1390–6.CrossRefPubMed

40.

Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GY. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest. 2010;138(5):1093–100.CrossRefPubMed

41.

De Vleeschouwer S, Van Calenbergh F, van Loon J, Nuttin B, Goffin J, Plets C. Risk analysis of thrombo-embolic and recurrent bleeding events in the management of intracranial haemorrhage due to oral anticoagulation. Acta Chir Belg. 2005;105(3):268–74.CrossRefPubMed

42.

Pollack CV Jr, Reilly PA, Weitz JI. Dabigatran reversal with idarucizumab. N Engl J Med. 2017;377(17):1691–2.PubMed

43.

Gage BF, van Walraven C, Pearce L, Hart RG, Koudstaal PJ, Boode BS, et al. Selecting patients with atrial fibrillation for anticoagulation: stroke risk stratification in patients taking aspirin. Circulation. 2004;110(16):2287–92.CrossRefPubMed

44.

Lip GY, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation. Chest. 2010;137(2):263–72.CrossRefPubMed

45.

Fang MC, Go AS, Chang Y, Borowsky LH, Pomernacki NK, Udaltsova N, et al. A new risk scheme to predict warfarin-associated hemorrhage: the ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation) Study. J Am Coll Cardiol. 2011;58(4):395–401.CrossRefPubMedPubMedCentral

46.

O'Brien EC, Simon DN, Thomas LE, Hylek EM, Gersh BJ, Ansell JE, et al. The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation. Eur Heart J. 2015;36(46):3258–64.PubMedPubMedCentral

47.

Apostolakis S, Lane DA, Buller H, Lip GY. Comparison of the CHADS2, CHA2DS2-VASc and HAS-BLED scores for the prediction of clinically relevant bleeding in anticoagulated patients with atrial fibrillation: the AMADEUS trial. Thromb Haemost. 2013;110(5):1074–9.CrossRefPubMed

48.

Chan KH, Ka-Kit Leung G, Lau KK, Liu S, Lui WM, Lau CP, et al. Predictive value of the HAS-BLED score for the risk of recurrent intracranial hemorrhage after first spontaneous intracranial hemorrhage. World Neurosurg. 2014;82(1–2):e219–23.CrossRefPubMed

49.

Raparelli V, Proietti M, Cangemi R, Lip GY, Lane DA, Basili S. Adherence to oral anticoagulant therapy in patients with atrial fibrillation. Focus on non-vitamin K antagonist oral anticoagulants. Thromb Haemost. 2017;117(2):209–18.CrossRefPubMed

50.

Rivera-Caravaca JM, Roldan V, Esteve-Pastor MA, et al. Cessation of oral anticoagulation is an important risk factor for stroke and mortality in atrial fibrillation patients. Thromb Haemost. 2017;117(7):1448–54.CrossRefPubMed

51.

Cannegieter SC, Rosendaal FR, Briet E. Thromboembolic and bleeding complications in patients with mechanical heart valve prostheses. Circulation. 1994;89(2):635–41.CrossRefPubMed

52.

Labaf A, Grzymala-Lubanski B, Stagmo M, Lövdahl S, Wieloch M, Själander A, et al. Thromboembolism, major bleeding and mortality in patients with mechanical heart valves—a population-based cohort study. Thromb Res. 2014;134(2):354–9.CrossRefPubMed

53.

Ogata T, Yasaka M, Wakugawa Y, Inoue T, Ibayashi S, Okada Y. Deep venous thrombosis after acute intracerebral hemorrhage. J Neurol Sci. 2008;272(1–2):83–6.CrossRefPubMed

54.

Pasquini M, Charidimou A, van Asch CJ, et al. Variation in restarting antithrombotic drugs at hospital discharge after intracerebral hemorrhage. Stroke. 2014;45(9):2643–8.CrossRefPubMed

55.

Larsen TB, Skjoth F, Grove EL, Nielsen PB, Christensen TD. Effectiveness of self-managed oral anticoagulant therapy in patients with recurrent venous thromboembolism. A propensity-matched cohort study. Thromb Haemost. 2016;116(3):524–9.PubMed

56.

Oudega R, Hoes AW, Moons KG. The Wells rule does not adequately rule out deep venous thrombosis in primary care patients. Ann Intern Med. 2005;143(2):100–7.CrossRefPubMed

57.

Wicki J, Perneger TV, Junod AF, Bounameaux H, Perrier A. Assessing clinical probability of pulmonary embolism in the emergency ward: a simple score. Arch Intern Med. 2001;161(1):92–7.CrossRefPubMed

58.

Biffi A, Kuramatsu JB, Leasure A, Kamel H, Kourkoulis C, Schwab K, et al. Oral anticoagulation and functional outcome after intracerebral hemorrhage. Ann Neurol. 2017;82(5):755–65.CrossRefPubMed

59.

Aguilar MI, Hart RG, Kase CS, Freeman WD, Hoeben BJ, García RC, et al. Treatment of warfarin-associated intracerebral hemorrhage: literature review and expert opinion. Mayo Clin Proc. 2007;82(1):82–92.CrossRefPubMed

60.

Maeda K, Koga M, Okada Y, Kimura K, Yamagami H, Okuda S, et al. Nationwide survey of neuro-specialists’ opinions on anticoagulant therapy after intracerebral hemorrhage in patients with atrial fibrillation. J Neurol Sci. 2012;312(1–2):82–5.CrossRefPubMed

61.

Ruff CT, Giugliano RP, Braunwald E, Hoffman EB, Deenadayalu N, Ezekowitz MD, et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet (London, England). 2014;383(9921):955–62.CrossRef

62.

Chandra D, Gupta A, Grover V, Kumar Gupta V. When should you restart anticoagulation in patients who suffer an intracranial bleed who also have a prosthetic valve? Interact Cardiovasc Thorac Surg. 2013;16(4):520–3.CrossRefPubMedPubMedCentral

63.

Becattini C, Sembolini A, Paciaroni M. Resuming anticoagulant therapy after intracerebral bleeding. Vasc Pharmacol. 2016;84:15–24.CrossRef

64.

Macellari F, Paciaroni M, Agnelli G, Caso V. Neuroimaging in intracerebral hemorrhage. Stroke. 2014;45(3):903–8.CrossRefPubMed

65.

Lip GYH, Collet JP, de Caterina R, Fauchier L, Lane DA, Larsen TB, et al. Antithrombotic therapy in atrial fibrillation associated with valvular heart disease: executive summary of a joint consensus document from the European Heart Rhythm Association (EHRA) and European Society of Cardiology Working Group on Thrombosis, endorsed by the ESC Working Group on Valvular Heart Disease, Cardiac Arrhythmia Society of Southern Africa (CASSA), Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), South African Heart (SA Heart) Association and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLEACE). Thromb Haemost. 2017;117(12):2215–36.CrossRefPubMed

66.

Hart RG, Pearce LA, Aguilar MI. Adjusted-dose warfarin versus aspirin for preventing stroke in patients with atrial fibrillation. Ann Intern Med. 2007;147(8):590–2.CrossRefPubMed

67.

Chatterjee S, Sardar P, Biondi-Zoccai G, Kumbhani DJ. New oral anticoagulants and the risk of intracranial hemorrhage: traditional and Bayesian meta-analysis and mixed treatment comparison of randomized trials of new oral anticoagulants in atrial fibrillation. JAMA Neurol. 2013;70(12):1486–90.PubMed

68.

Hagii J, Tomita H, Metoki N, Saito S, Shiroto H, Hitomi H, et al. Characteristics of intracerebral hemorrhage during rivaroxaban treatment: comparison with those during warfarin. Stroke. 2014;45(9):2805–7.CrossRefPubMed

69.

Inohara T, Xian Y, Liang L, Matsouaka RA, Saver JL, Smith EE, et al. Association of intracerebral hemorrhage among patients taking non-vitamin K antagonist vs vitamin K antagonist oral anticoagulants with in-hospital mortality. JAMA. 2018;319(5):463–73.CrossRefPubMedPubMedCentral

70.

Akin M, Schafer A, Akin I, Widder J, Brehm M. Use of new oral anticoagulants in the treatment of venous thromboembolism and thrombotic prophylaxis. Cardiovasc Hematol Disord Drug Targets. 2015;15(2):92–6.CrossRefPubMed

71.

Hirschl M, Kundi M. New oral anticoagulants in the treatment of acute venous thromboembolism—a systematic review with indirect comparisons. Vasa. 2014;43(5):353–64.CrossRefPubMed

72.

Lyon C, Mathern S, Devitt J, DeSanto K. Rivaroxaban vs. warfarin for treatment of DVT and PE. Am Fam Physician. 2017;96(8):532–3.PubMed

73.

Schulman S, Ageno W, Konstantinides SV. Venous thromboembolism: past, present and future. Thromb Haemost. 2017;117(7):1219–29.CrossRefPubMed

74.

Sindet-Pedersen C, Langtved Pallisgaard J, Staerk L, Gerds TA, Fosbøl EL, Torp-Pedersen C, et al. Comparative safety and effectiveness of rivaroxaban versus VKAs in patients with venous thromboembolism. A Danish nationwide registry-based study. Thromb Haemost. 2017;117(6):1182–91.CrossRefPubMed

75.

Di Nisio M, Vedovati MC, Riera-Mestre A, et al. Treatment of venous thromboembolism with rivaroxaban in relation to body weight. A sub-analysis of the EINSTEIN DVT/PE studies. Thromb Haemost. 2016;116(4):739–46.PubMed

76.

Orken DN, Kenangil G, Ozkurt H, Guner C, Gundogdu L, Basak M, et al. Prevention of deep venous thrombosis and pulmonary embolism in patients with acute intracerebral hemorrhage. Neurologist. 2009;15(6):329–31.CrossRefPubMed

77.

Lip GYH, Lane DA. Matching the NOAC to the patient: remember the modifiable bleeding risk factors. J Am Coll Cardiol. 2015;66(21):2282–4.CrossRefPubMed

78.

Horstmann S, Zugck C, Krumsdorf U, Rizos T, Rauch G, Geis N, et al. Left atrial appendage occlusion in atrial fibrillation after intracranial hemorrhage. Neurology. 2014;82(2):135–8.CrossRefPubMedPubMedCentral

79.

Lane DA, Lip GY. Anticoagulation intensity for elderly atrial fibrillation patients: should we use a conventional INR target (2.0 to 3.0) or a lower range? Thromb Haemost. 2010;103(2):254–6.CrossRefPubMed

80.

van Nieuwenhuizen KM, van der Worp HB, Algra A, et al. Apixaban versus Antiplatelet drugs or no antithrombotic drugs after anticoagulation-associated intraCerebral HaEmorrhage in patients with Atrial Fibrillation (APACHE-AF): study protocol for a randomised controlled trial. Trials. 2015;16:393.CrossRefPubMedPubMedCentral

81.

Start or Stop Anticoagulants Randomised Trial (SoSTART) [https://clinicaltrials.gov/ct2/show/NCT03153150].

Title: Anticoagulation Resumption After Intracerebral Hemorrhage
Authors: Yan-guang Li
Gregory Y. H. Lip
Publication date: 01-07-2018
Publisher: Springer US
Published in: Current Atherosclerosis Reports / Issue 7/2018
Print ISSN: 1523-3804
Electronic ISSN: 1534-6242
DOI: https://doi.org/10.1007/s11883-018-0733-y

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