Time trends in intracranial bleeding associated with direct oral anticoagulants: a 5-year cohort study

CMAJ Open
Kerstin HoggIan G Stiell

Abstract

Over the past 5 years, dabigatran, rivaroxaban and apixaban were approved for stroke prevention. Phase III studies have shown a lower risk of intracranial bleeding with these direct oral anticoagulants than with warfarin; however, there is a lack of real-life data to validate this. We analyzed time trends in atraumatic intracranial bleeding from 2009 to 2013 among patients prescribed oral anticoagulants and those not prescribed oral anticoagulants. We used ICD-10-CA (enhanced Canadian version of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems) codes to identify all patients with atraumatic intracranial bleeding who presented to our neurosurgical centre (serving a population of more than 1.2 million). Trained researchers extracted data on anticoagulant medications used in the week before diagnosis of the intracranial bleed. Provincial prescription data for oral anticoagulants were obtained from IMS Brogan CompuScript Market Dynamics. The primary outcome was the time trend in incident intracranial bleeds associated with oral anticoagulation during the period 2009-2013. The secondary outcomes were the time trend in intracranial bleeds not associated with oral anticoagulatio...Continue Reading

References

Mar 27, 2013·European Journal of Internal Medicine·R JoppiUNKNOWN Italian Horizon Scanning Project
Apr 9, 2013·Journal of the American College of Cardiology·Torben Bjerregaard LarsenGregory Y H Lip
Mar 22, 2014·Current Medical Research and Opinion·François LalibertéPatrick Lefebvre
Mar 25, 2014·European Heart Journal·Jonathan P PicciniUNKNOWN ROCKET AF Investigators
Jul 25, 2014·BMJ : British Medical Journal·Thomas J MooreDonald R Mattison

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Citations

Apr 27, 2016·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Kerstin HoggJecko Thachil
Feb 20, 2018·British Journal of Clinical Pharmacology·Satoshi UeshimaToshiya Katsura

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