Biffi A, et al. - Physicians designed this study to ascertain whether Oral Anticoagulation Treatment (OAT) resumption after Intracerebral Hemorrhage (ICH) was correlated with long-term outcome, accounting for ICH location (i.e. lobar vs. non-lobar). Regardless of hematoma location, novel evidence of an association between OAT resumption and outcome following ICH was proposed. These findings supported conducting randomized trials to investigate risks and benefits of OAT resumption after ICH.

• Individual patient data was meta-analyzed from:
  • The multi-center RETRACE study (n=542)
  • A US-based single-center ICH study (n=261)
  • The Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study (n=209).
• They determined whether, within 1 year from ICH, OAT resumption was correlated with: 1) mortality; 2) favorable functional outcome (modified Rankin Scale [mRS] 0-3); stroke incidence.
• Using propensity score matching and Cox regression models, the physicians separately analyzed non-lobar and lobar ICH cases.

• A total of 1012 OAT-related ICH survivors (633 non-lobar and 379 lobar) were included.
• 178/633 (28%) resumed OAT among non-lobar ICH survivors, while 86/379 (23%) lobar ICH survivors did.
• OAT resumption after non-lobar ICH was correlated with decreased mortality (Hazard Ratio [HR]=0.25, 95% Confidence Interval [CI]=0.14-0.44, p<0.0001) and improved functional outcome (HR=4.22, 95% CI=2.57-6.94, p<0.0001) in multivariable analyses.
• Moreover, OAT resumption after lobar ICH was correlated with decreased mortality (HR=0.29, 95% CI=0.17-0.45, p<0.0001) and favorable functional outcome (HR=4.08, 95% CI=2.48-6.72, p<0.0001).
• In both lobar and non-lobar ICH (both p<0.01), OAT resumption was also correlated with decreased all-cause stroke incidence.