Risk Factors for Intracerebral Hemorrhage in Patients With Atrial Fibrillation on Non-Vitamin K Antagonist Oral Anticoagulants for Stroke Prevention

Maurizio Paciaroni; Giancarlo Agnelli; Michela Giustozzi; Valeria Caso; Elisabetta Toso; Filippo Angelini; Isabella Canavero; Giuseppe Micieli; Kateryna Antonenko; Alessandro Rocco; Marina Diomedi; Aristeidis H Katsanos; Ashkan Shoamanesh; Sotirios Giannopoulos; Walter Ageno; Samuela Pegoraro; Jukka Putaala; Daniel Strbian; Hanne Sallinen; Brian C Mac Grory; Karen L Furie; Christoph Stretz; Michael E Reznik; Andrea Alberti; Michele Venti; Maria Giulia Mosconi; Maria Cristina Vedovati; Laura Franco; Giorgia Zepponi; Michele Romoli; Andrea Zini; Laura Brancaleoni; Letizia Riva; Giorgio Silvestrelli; Alfonso Ciccone; Maria Luisa Zedde; Elisa Giorli; Maria Kosmidou; Evangelos Ntais; Lina Palaiodimou; Panagiotis Halvatsiotis; Tiziana Tassinari; Valentina Saia; Raffaele Ornello; Simona Sacco; Fabio Bandini; Michelangelo Mancuso; Giovanni Orlandi; Elena Ferrari; Alessandro Pezzini; Loris Poli; Manuel Cappellari; Stefano Forlivesi; Alberto Rigatelli; Shadi Yaghi; Erica Scher; Jennifer A Frontera; Luca Masotti; Elisa Grifoni; Pietro Caliandro; Aurelia Zauli; Giuseppe Reale; Simona Marcheselli; Antonio Gasparro; Valeria Terruso; Valentina Arnao; Paolo Aridon; Azmil H Abdul-Rahim; Jesse Dawson; Carlo Emanuele Saggese; Francesco Palmerini; Boris Doronin; Vera Volodina; Danilo Toni; Angela Risitano; Erika Schirinzi; Massimo Del Sette; Piergiorgio Lochner; Serena Monaco; Marina Mannino; Rossana Tassi; Francesca Guideri; Maurizio Acampa; Giuseppe Martini; Enrico Maria Lotti; Marina Padroni; Leonardo Pantoni; Silvia Rosa; Pierluigi Bertora; George Ntaios; Dimitrios Sagris; Antonio Baldi; Cataldo D'Amore; Nicola Mumoli; Cesare Porta; Licia Denti; Alberto Chiti; Francesco Corea; Monica Acciarresi; Yuriy Flomin; Nemanja Popovic; Georgios Tsivgoulis

doi:10.1161/STROKEAHA.120.031827

Risk Factors for Intracerebral Hemorrhage in Patients With Atrial Fibrillation on Non-Vitamin K Antagonist Oral Anticoagulants for Stroke Prevention

Stroke. 2021 Apr;52(4):1450-1454. doi: 10.1161/STROKEAHA.120.031827. Epub 2021 Mar 4.

Authors

Maurizio Paciaroni¹, Giancarlo Agnelli¹, Michela Giustozzi¹, Valeria Caso¹, Elisabetta Toso², Filippo Angelini², Isabella Canavero³, Giuseppe Micieli³, Kateryna Antonenko⁴, Alessandro Rocco⁵, Marina Diomedi⁵, Aristeidis H Katsanos⁶, Ashkan Shoamanesh⁶, Sotirios Giannopoulos⁷, Walter Ageno⁸, Samuela Pegoraro⁸, Jukka Putaala⁹, Daniel Strbian⁹, Hanne Sallinen⁹, Brian C Mac Grory¹⁰, Karen L Furie¹¹, Christoph Stretz¹¹, Michael E Reznik¹¹, Andrea Alberti¹, Michele Venti¹, Maria Giulia Mosconi¹, Maria Cristina Vedovati¹, Laura Franco¹, Giorgia Zepponi¹, Michele Romoli¹², Andrea Zini¹³, Laura Brancaleoni¹³, Letizia Riva¹⁴, Giorgio Silvestrelli¹⁵, Alfonso Ciccone¹⁵, Maria Luisa Zedde¹⁶, Elisa Giorli¹⁷, Maria Kosmidou¹⁸, Evangelos Ntais⁷, Lina Palaiodimou¹⁹, Panagiotis Halvatsiotis²⁰, Tiziana Tassinari²¹, Valentina Saia²¹, Raffaele Ornello²², Simona Sacco²², Fabio Bandini²³, Michelangelo Mancuso²⁴, Giovanni Orlandi²⁴, Elena Ferrari²⁴, Alessandro Pezzini²⁵, Loris Poli²⁵, Manuel Cappellari²⁶, Stefano Forlivesi²⁶, Alberto Rigatelli²⁷, Shadi Yaghi²⁸, Erica Scher²⁸, Jennifer A Frontera²⁸, Luca Masotti²⁹, Elisa Grifoni²⁹, Pietro Caliandro³⁰, Aurelia Zauli³¹, Giuseppe Reale³¹, Simona Marcheselli³², Antonio Gasparro³³, Valeria Terruso³³, Valentina Arnao³⁴, Paolo Aridon³⁴, Azmil H Abdul-Rahim³⁵, Jesse Dawson³⁵, Carlo Emanuele Saggese³⁶, Francesco Palmerini³⁷, Boris Doronin³⁸, Vera Volodina³⁸, Danilo Toni³⁹, Angela Risitano³⁹, Erika Schirinzi⁴⁰, Massimo Del Sette⁴⁰, Piergiorgio Lochner⁴¹, Serena Monaco⁴², Marina Mannino⁴², Rossana Tassi⁴³, Francesca Guideri⁴³, Maurizio Acampa⁴³, Giuseppe Martini⁴³, Enrico Maria Lotti⁴⁴, Marina Padroni⁴⁴, Leonardo Pantoni⁴⁵, Silvia Rosa⁴⁶, Pierluigi Bertora⁴⁵, George Ntaios⁴⁷, Dimitrios Sagris⁴⁷, Antonio Baldi⁴⁸, Cataldo D'Amore⁴⁸, Nicola Mumoli⁴⁹, Cesare Porta⁴⁹, Licia Denti⁵⁰, Alberto Chiti⁵¹, Francesco Corea⁵², Monica Acciarresi⁵², Yuriy Flomin⁵³, Nemanja Popovic⁵⁴, Georgios Tsivgoulis¹⁹

Affiliations

¹ Stroke Unit and Division of Cardiovascular Medicine, University of Perugia, Italy (M. Paciaroni, G.A., M.G., V.C., A.A., M.V., M.G.M., M.C.V., L.F., G.Z.).
² Division of Cardiology, Città della Salute e della Scienza Hospital, University of Torino, Italy (E.T., F.A.).
³ Emergency Neurology, IRCCS Casimiro Mondino Foundation, Pavia, Italy (I.C., G. Micieli).
⁴ Department of Neurology, Bogomolets National Medical University, Kyiv, Ukraine (K.A.).
⁵ Stroke Unit, Department of Systems Medicine, University of Tor Vergata, Rome, Italy (A. Rocco, M.D.).
⁶ Department of Medicine (Neurology), McMaster University/Population Health Research Institute, Hamilton, Canada (A.H.K., A.S.).
⁷ Department of Neurology, University of Ioannina School of Medicine, Greece (S.G., E.N.).
⁸ Department of Medicine, University of Insubria, Ospedale di Circolo, Varese, Italy (W.A., S.P.).
⁹ Department of Neurology, Helsinki University Hospital and Neurosciences University of Helsinki, Finland (J.P., D. Strbian, H.S.).
¹⁰ Department of Neurology, Duke University School of Medicine, Durham, NC (B.C.M.G.).
¹¹ Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI (K.L.F., C.S., M.E.R.).
¹² Neurology Unit, Rimini "Infermi" Hospital-AUSL Romagna, Rimini, Italy (M. Romoli).
¹³ Department of Neurology and Stroke Center, IRCCS Istituto di Scienze Neurologiche di Bologna (A. Zini, L.B.), Maggiore Hospital, Bologna, Italy.
¹⁴ Division of Cardiology (L.R.), Maggiore Hospital, Bologna, Italy.
¹⁵ S.C. di Neurologia e S.S. di Stroke Unit, ASST di Mantova, Italy (G.S., A. Ciccone).
¹⁶ Neurology Unit, Stroke Unit, Local Health Unit-IRCCS of Reggio Emilia, Italy (M.L.Z.).
¹⁷ Department of Neurology, Stroke Unit, Sant'Andrea Hospital, La Spezia, Italy (E. Giorli).
¹⁸ First Department of Internal Medicine, University of Ioannina School of Medicine, Greece (M.K.).
¹⁹ Second Department of Neurology, "Attikon" Hospital, National and Kapodistrian University of Athens, School of Medicine, Greece (L. Palaiodimou, G.T.).
²⁰ Second Department of Internal Medicine "Attikon" University Hospital Medical School, National and Kapodistrian University of Athens, Greece (P.H.).
²¹ Department of Neurology and Stroke Unit, Santa Corona Hospital, Pietra Ligure (Savona), Italy (T.T., V.S.).
²² Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Italy (R.O., S.S.).
²³ Department of Neurology, Ospedale San Paolo, Savona, Italy (F.B.).
²⁴ Department of Clinical and Experimental Medicine, Neurological Institute, University of Pisa, Italy (M. Mancuso, G.O., E.F.).
²⁵ Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Italy (A.P., L. Poli).
²⁶ SSO Stroke Unit, UO Neurologia, DAI di Neuroscienze, AOUI Verona, Italy (M.C., S.F.).
²⁷ Pronto Soccorso, Ospedale Borgo Trento, DAI Emergenza e Accettazione, AOUI Verona, Italy (A. Rigatelli).
²⁸ Department of Neurology, NYU Langone Health, New York, NY (S.Y., E. Scher, J.A.F.).
²⁹ Internal Medicine, San Giuseppe Hospital, Empoli, Italy (L.M., E. Grifoni).
³⁰ Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (P.C.).
³¹ Department of Geriatrics, Neurosciences and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy (A. Zauli, G.R.).
³² Humanitas Clinical and Research Center-IRCCS, Rozzano, Milano, Italy (S. Marcheselli).
³³ Neurologia, Ospedali Riuniti, Palermo, Italy (A.G., V.T.).
³⁴ Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Italy (V.A., P.A.).
³⁵ Medical School and Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (A.H.A.-R., J.D.).
³⁶ Unità di Terapia Neurovascolare, Ospedale "Fabrizio Spaziani," Frosinone, Italy (C.E.S.).
³⁷ Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy (F.P.).
³⁸ Municipal Budgetary Healthcare Institution of Novosibirsk, City Clinical Hospital No. 1, Novosibirsk State Medical University, Russia (B.D., V.V.).
³⁹ Department of Human Neurosciences, Sapienza University of Rome, Italy (D.T., A. Risitano).
⁴⁰ Struttura Complessa di Neurologia, Ente Ospedaliero Ospedali Galliera, Genoa, Italy (E. Schirinzi, M.D.S.).
⁴¹ Department of Neurology, Saarland University, Medical Center, Homburg, Germany (P.L.).
⁴² Stroke Unit, Ospedale Civico, Palermo, Italy (S. Monaco, M. Mannino).
⁴³ Stroke Unit, AOU Senese, Siena, Italy (R.T., F.G., M. Acampa, G. Martini).
⁴⁴ U.O. Neurologia Presidio Ospedaliero di Ravenna Azienda USL della Romagna, Italy (E.M.L., M. Padroni).
⁴⁵ 'L. Sacco' Department of Biomedical and Clinical Sciences, University of Milan, Italy (L. Pantoni, P.B.).
⁴⁶ Neurology Unit, ASST Fatebenefratelli-Sacco, Milan, Italy (S.R.).
⁴⁷ Department of Medicine, University of Thessaly, Larissa, Greece (G.N., D. Sagris).
⁴⁸ Stroke Unit, Ospedale di Portogruaro, Venice, Italy (A.B., C.D.).
⁴⁹ Department of Internal Medicine, Magenta Hospital, Italy (N.M., C.P.).
⁵⁰ Stroke Unit, Dipartimento Geriatrico Riabilitativo, University of Parma, Italy (L.D.).
⁵¹ Neurologia, Ospedale Apuano, Massa Carrara, Italy (A. Chiti).
⁵² UO Gravi Cerebrolesioni, San Giovanni Battista Hospital, Foligno, Italy (F.C., M. Acciarresi).
⁵³ Stroke and Neurorehabilitation Unit, MC Universal Clinic 'Oberig' Kyiv, Ukraine (Y.F.).
⁵⁴ Clinic of Neurology, Clinical Center of Vòsvodina, University of Novi Sad, Serbia (N.P.).

Abstract

[Figure: see text].

Keywords: atrial fibrillation; cerebral hemorrhage; logistic models; risk factors; white matter.

Publication types

Multicenter Study

MeSH terms

Administration, Oral
Aged
Aged, 80 and over
Antithrombins / therapeutic use*
Atrial Fibrillation / complications*
Case-Control Studies
Cerebral Hemorrhage / chemically induced*
Female
Humans
Male
Middle Aged
Prospective Studies
Risk Factors
Stroke / etiology
Stroke / prevention & control*

Substances

Antithrombins