DOACs Beneficial for Patients With A-Fib and Prior Intracranial Bleeding

FRIDAY, Oct. 23, 2026 (HealthDay News) -- For patients with atrial fibrillation (AF) and prior intracranial bleeding, direct oral anticoagulants (DOACs) are associated with a reduced risk for ischemic stroke (IS) and death, without an increased risk for intracranial bleeding, according to a study published online Oct. 21 in Neurology.Paula Tiili, M.D., from the Helsinki University Hospital, and colleagues used linked administrative registries of patients with first-ever AF diagnosed in 2010 to 2018 and intracranial bleeding at least 120 days earlier to examine competing risks for recurrent intracranial bleeding, IS, and death from other causes according to anticoagulation strategy. Based on drug purchases, patients were classified as receiving DOACs, warfarin, or no OAC.Among 1,502 patients, 15, 29, and 56 percent received DOACs, warfarin, and no OAC, respectively. The researchers found that the adjusted absolute risks for IS were 0.7, 2.1, and 4.1 percent, respectively; adjusted absolute risks for intracranial bleeding were 1.2, 2.7, and 1.9 percent, respectively; and adjusted absolute risks for death from other causes were 4.7, 8.6, and 14.7 percent, respectively, at one year. DOAC use was associated with lower risks for IS and death compared with no OAC (hazard ratios, 0.17 and 0.20, respectively), with no increased risk for intracranial bleeding. Lower risks for IS and death were seen in association with warfarin use (hazard ratios, 0.49 and 0.60, respectively), and the risk for intracranial bleeding was increased (hazard ratio, 1.85)."Our findings may help clinicians make more individualized treatment decisions when trying to prevent stroke in people with a-fib and prior brain bleeds," Tiili said in a statement.Several authors disclosed ties to the biopharmaceutical industry.Abstract/Full Text (subscription or payment may be required).Sign up for our weekly HealthDay newsletter

DOACs Beneficial for Patients With A-Fib and Prior Intracranial Bleeding

Related Stories

FDA Patient, Consumer Reps Often Tied To Pharma-Funded Groups

GLP-1s Show Benefit For Kids With Type 2 Diabetes

Risk Of Death, Major Disease High Following Type 2 Diabetes Diagnosis

Study Looks at Patient Experiences With Sedative Contaminating Fentanyl