Journal Article (Review Article)

DZNE-2021-01565

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Intrazerebrale Blutungen unter Plättchenaggregationshemmung und oraler Antikoagulation bei Patienten mit zerebraler Amyloidangiopathie.

Haussmann, R. (Corresponding author)Extern*DZNE* ; Homeyer, P. ; Haußmann, M. ; Brandt, D. M.DZNE* ; Donix, M.DZNE* ; Puetz, V. ; Linn, J.

2022
Springer Heidelberg

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Please use a persistent id in citations: doi:10.1007/s00115-021-01206-w

Abstract: Oral anticoagulation in patients with cerebral amyloid angiopathy is a therapeutic challenge. The association of cerebral amyloid angiopathy with intracerebral hemorrhage, a high mortality of intracerebral hemorrhage especially under oral anticoagulation and the high risk of recurrent bleeding require a multidisciplinary approach and a thorough risk-benefit analysis. Vitamin K antagonists increase the risk of intracerebral bleeding and the accompanying mortality by 60% and should be avoided if possible or reserved for special clinical situations (e.g. mechanical aortic valve replacement). Treatment with novel oral anticoagulants and antiplatelet drugs also increases the risk of cerebral bleeding and therefore needs a thorough risk-benefit evaluation. An interventional left atrial appendage closure is a promising therapeutic option especially in patients with an absolute arrythmia with atrial fibrillation. Furthermore, other clinical implications in patients with cerebral amyloid angiopathy are the subject of this review of the literature, such as special characteristics after acute ischemic stroke and the necessary secondary prophylaxis, with previous intracerebral hemorrhage and in patients with cognitive deficits.

Keyword(s): Anticoagulants: therapeutic use (MeSH) ; Atrial Fibrillation: complications (MeSH) ; Atrial Fibrillation: drug therapy (MeSH) ; Cerebral Amyloid Angiopathy: complications (MeSH) ; Cerebral Amyloid Angiopathy: diagnosis (MeSH) ; Cerebral Amyloid Angiopathy: drug therapy (MeSH) ; Cerebral Hemorrhage: chemically induced (MeSH) ; Cerebral Hemorrhage: complications (MeSH) ; Cerebral Hemorrhage: diagnosis (MeSH) ; Humans (MeSH) ; Ischemic Stroke (MeSH) ; Stroke: complications (MeSH) ; Cerebral amyloid angiopathy ; Interventional left atrial appendage closure ; Intracerebral hemorrhage ; Oral anticoagulation ; Platelet inhibition

Note: (CC BY)

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Contributing Institute(s):

1. Clinical planning and intersite group (AG Donix)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

Appears in the scientific report 2022

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Database coverage:
; ; ; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; DEAL Springer ; Ebsco Academic Search ; Essential Science Indicators ; IF < 5 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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