{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T13:47:26Z","timestamp":1767707246706},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","license":[{"start":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T00:00:00Z","timestamp":1713312000000},"content-version":"vor","delay-in-days":16,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Intracranial haemorrhage (ICH) is the most feared haemorrhagic complication of oral anticoagulant therapy (OAT), although the risk is significantly lower with direct oral anticoagulants (DOACs) compared with warfarin. Intracranial haemorrhage is generally considered, by clinicians, to be an absolute contraindication to starting or resuming OAT in patients with atrial fibrillation (AF). On the other hand, the pivotal trials with DOACs excluded patients with previous ICH. Observational studies actually indicate a net clinical benefit in favour of DOAC in patients with AF and previous ICH. This benefit is confirmed by randomized clinical trials which, however, have the limitation of the small number of cases, but larger clinical trials comparing DOACs vs. aspirin or no therapy are underway. While OAT is certainly contraindicated in patients with lobar ICH and cerebral amyloid angiopathy, in other cases, the decision must be made in the individual patient through an accurate balance between thromboembolic risk and haemorrhagic risk and a multidisciplinary cardio-neurological evaluation.<\/jats:p>","DOI":"10.1093\/eurheartjsupp\/suae020","type":"journal-article","created":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T11:40:39Z","timestamp":1713354039000},"page":"i64-i68","source":"Crossref","is-referenced-by-count":1,"title":["Cerebral haemorrhage in the patient with atrial fibrillation: do we employ the direct oral anticoagulants without waiting too long?"],"prefix":"10.1093","volume":"26","author":[{"given":"Gloria","family":"Vassiliki\u2019 Coutsoumbas","sequence":"first","affiliation":[{"name":"Cardiology Unit, Maggiore Hospital , Bologna"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Di Pasquale","sequence":"additional","affiliation":[{"name":"Coordination of the Cardiology and Cardiovascular Surgery Network in Emilia-Romagna Region"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,4,17]]},"reference":[{"key":"2024041706394991400_suae020-B1","doi-asserted-by":"crossref","first-page":"e282","DOI":"10.1161\/STR.0000000000000407","article-title":"2022 Guideline for the management of patients with spontaneous intracerebral hemorrhage: a guideline from the American Heart Association\/American Stroke Association","volume":"53","author":"Greenberg","year":"2022","journal-title":"Stroke"},{"key":"2024041706394991400_suae020-B2","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1016\/S0140-6736(13)62343-0","article-title":"Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials","volume":"383","author":"Ruff","year":"2014","journal-title":"Lancet"},{"key":"2024041706394991400_suae020-B3","first-page":"384","article-title":"Angiopatia amiloide cerebrale e fibrillazione atriale: un pericoloso connubio","volume":"20","author":"Merella","year":"2019","journal-title":"G Ital Cardiol (Rome)"},{"key":"2024041706394991400_suae020-B4","doi-asserted-by":"crossref","first-page":"e364","DOI":"10.1161\/STR.0000000000000375","article-title":"2021 Guideline for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline from the American Heart Association\/American Stroke Association","volume":"52","author":"Kleindorfer","year":"2021","journal-title":"Stroke"},{"key":"2024041706394991400_suae020-B5","doi-asserted-by":"crossref","first-page":"1612","DOI":"10.1093\/europace\/euab065","article-title":"2021 European Heart Rhythm Association practical guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation","volume":"23","author":"Steffel","year":"2021","journal-title":"Europace"},{"key":"2024041706394991400_suae020-B6","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1177\/2396987319841187","article-title":"Antithrombotic treatment for secondary prevention of stroke and other thrombo-embolic events in patients with stroke or transient ischemic attack and non-valvular atrial fibrillation: a European Stroke Organisation guideline","volume":"4","author":"Klijn","year":"2019","journal-title":"Eur Stroke J"},{"key":"2024041706394991400_suae020-B7","doi-asserted-by":"crossref","first-page":"2411","DOI":"10.1056\/NEJMoa2303048","article-title":"Early versus later anticoagulation for stroke with atrial fibrillation","volume":"388","author":"Fischer","year":"2023","journal-title":"N Engl J Med"},{"key":"2024041706394991400_suae020-B8","first-page":"3","article-title":"When does it seem appropriate to start a direct oral anticoagulant after an ischemic stroke associated with atrial fibrillation? 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