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. 2023 Jan 20;6(1):e1059.
doi: 10.1002/hsr2.1059. eCollection 2023 Jan.

Antithrombotic treatment after intracerebral hemorrhage: Surveys among stroke physicians in Scandinavia and the United Kingdom

Elisabeth Forfang  1   2 , Kristin Tveitan Larsen  1   2 , Rustam Al-Shahi Salman  3 , Simon M Bell  4 , Per Wester  5   6 , Eivind Berge  7 , Torgeir Bruun Wyller  1   2 , Ole Morten Rønning  1   8
Affiliations

Antithrombotic treatment after intracerebral hemorrhage: Surveys among stroke physicians in Scandinavia and the United Kingdom

Elisabeth Forfang et al. Health Sci Rep. .

Erratum in

Abstract

Background and aims: It is unclear whether patients with previous intracerebral hemorrhage (ICH) should receive antithrombotic treatment to prevent ischemic events. We assessed stroke physicians' opinions about this, and their views on randomizing patients in trials assessing this question.

Methods: We conducted three web-based surveys among stroke physicians in Scandinavia and the United Kingdom.

Results: Eighty-nine of 205 stroke physicians (43%) responded to the Scandinavian survey, 161 of 180 (89%) to the UK antiplatelet survey, and 153 of 289 (53%) to the UK anticoagulant survey. In Scandinavia, 19 (21%) stroke physicians were uncertain about antiplatelet treatment after ICH for ischemic stroke or transient ischemic attack (TIA) and 21 (24%) for prior myocardial infarction. In the United Kingdom, 116 (77%) were uncertain for ischemic stroke or TIA and 115 (717%) for ischemic heart disease. In Scandinavia, 32 (36%) were uncertain about anticoagulant treatment after ICH for atrial fibrillation, and 26 (29%) for recurrent deep vein thrombosis or pulmonary embolism. In the United Kingdom, 145 (95%) were uncertain about anticoagulants after ICH in at least some cases. In both regions combined, 191 of 250 (76%) would consider randomizing ICH survivors in a trial of starting versus avoiding antiplatelets, and 176 of 242 (73%) in a trial of starting versus avoiding anticoagulants.

Conclusion: Considerable proportions of stroke physicians in Scandinavia and the United Kingdom were uncertain about antithrombotic treatment after ICH. A clear majority would consider randomizing patients in trials assessing this question. These findings support the need for such trials.

Keywords: antithrombotic treatment; intracerebral hemorrhage; ischemic events; secondary prevention; stroke.

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Conflict of interest statement

R. A. S. received funding from the British Heart Foundation, paid to the University of Edinburgh, for the RESTART and SoSTART trials. The remaining authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A−C) Would you start or be uncertain about antithrombotic treatment after ICH in patients with the following indications? ICH, intracerebral hemorrhage.
Figure 2
Figure 2
(A−C) Would you start or be uncertain about antithrombotic treatment after ICH in the following locations? ICH, intracerebral hemorrhage.
See this image and copyright information in PMC

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