Highlight
This large Finnish registry study assessed the risks of recurrent intracranial bleeding, ischemic stroke, and mortality in atrial fibrillation (AF) patients with prior intracranial bleeding using direct oral anticoagulants (DOACs), warfarin, or no anticoagulation. Key findings include: 1) DOACs significantly reduce ischemic stroke and mortality risk without increasing intracranial bleeding risk; 2) Warfarin reduces stroke and death risk but increases intracranial bleeding risk; 3) Optimal warfarin management (high time in therapeutic range) is associated with better outcomes; 4) Anticoagulation decisions in this vulnerable group should be individualized given the competing risks and potential confounding.
Study Background
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For clinical reference; use professional judgment.
