![]() According to several studies, even with modern treatment approximately half of the patients with VKA-associated ICH die within 30 days. The location of ICH due to NOAC therapy is mainly intraparenchymal and subdural. According to the initial studies, the incidence of ICH due to NOAC therapy is 0.2-0.5% per year, compared to 0.3-0.8% per year among well-controlled VKA patients. The high mortality rate was largely due to ICH. A meta-analysis of the initial randomized studies showed that compared to VKA, treatment with NOAC reduces overall mortality among patients with atrial fibrillation (AF). Further on, non-vitamin K oral anticoagulants (NOAC) have been approved as a safer and more effective anticoagulant therapy compared to VKA in randomized, multicenter, clinical studies. For many years, vitamin K antagonists (VKA) were the only available oral anticoagulation therapy. Intracranial hemorrhage (ICH) is a serious, life-threatening, but fortunately rare complication of anticoagulation therapy. Conclusions: Our retrospective single-center study shows that the mortality rate with NOAC-related ICH is <40%, which makes it comparable to that with vitamin K antagonist-related ICH. The location of the ICH was mainly intraparenchymal and subdural. Ten patients (29%) had a favorable outcome with a modified Rankin Scale score ≤2 and 13 patients (38%) died. Eighteen patients were treated with rivaroxaban, 11 with dabigatran, and 5 with apixaban. The median CHA 2DS 2-VASc score was 3.4 and the median HAS-BLED score was 1.8. The main predisposing risk factors were age and arterial hypertension. Results: Thirty-four patients aged 77.8 ± 8.3 years with NOAC-related ICH were included. Risk for ischemic and bleeding events and clinical status upon admission and at discharge were evaluated using standard scales. ![]() Risk factors, type of NOAC, and location of ICH were evaluated. Methods: All consecutive patients admitted to a single center due to acute NOAC-related ICH from September 2012 until the beginning of 2017 were included. There are limited data on NOAC-related ICH prognosis. Background: Intracranial hemorrhage (ICH) is a serious, life-threatening, but fortunately rare complication of non-vitamin K oral anticoagulant (NOAC) therapy.
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