{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:23:17Z","timestamp":1792686197793,"version":"4.5.0"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2016,4,19]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>The risk of further intracranial hemorrhage (ICH) and the benefit of stroke risk reduction with the use of oral anticoagulants for patients who have atrial fibrillation with a history of ICH remain unclear. We aimed to investigate the risks and benefits in patients who have atrial fibrillation with a previous ICH treated with warfarin or antiplatelet drugs in comparison with no antithrombotic therapies.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              This study used the National Health Insurance Research Database in Taiwan. Among 307\u2009640 patients who have atrial fibrillation with a CHA\n              <jats:sub>2<\/jats:sub>\n              DS\n              <jats:sub>2<\/jats:sub>\n              -VASc score \u22672, 12\u2009917 patients with a history of ICH were identified and were assigned to 1 of 3 groups, that is, no treatment, antiplatelet therapy, and warfarin. Among patients with previous ICH, the rate of ICH and ischemic stroke in untreated patients was 4.2 and 5.8 per 100 person-years, respectively. The annual ICH and ischemic stroke rates in warfarin users were 5.9% and 3.4%, respectively. Among users of antiplatelet agents, the rates were 5.3% per year and 5.2% per year, respectively. The number needed to treat for preventing 1 ischemic stroke was lower than the number needed to harm for producing 1 ICH with warfarin use for patients with a CHA\n              <jats:sub>2<\/jats:sub>\n              DS\n              <jats:sub>2<\/jats:sub>\n              -VASc score \u22676 (37 versus 56). The number needed to treat was higher than the number needed to harm for patients with a CHA\n              <jats:sub>2<\/jats:sub>\n              DS\n              <jats:sub>2<\/jats:sub>\n              -VASc score &lt;6 (63 versus 53).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>\n              Warfarin use may be beneficial for patients who have atrial fibrillation with a previous ICH having a CHA\n              <jats:sub>2<\/jats:sub>\n              DS\n              <jats:sub>2<\/jats:sub>\n              -VASc score \u22676. Whether the use of non\u2013vitamin K antagonist oral anticoagulants could lower the threshold for treatment deserves further study.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.115.019794","type":"journal-article","created":{"date-parts":[[2016,3,12]],"date-time":"2016-03-12T04:19:44Z","timestamp":1457756384000},"page":"1540-1547","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":109,"title":["Use of Oral Anticoagulants for Stroke Prevention in Patients With Atrial Fibrillation Who Have a History of Intracranial Hemorrhage"],"prefix":"10.1161","volume":"133","author":[{"given":"Tze-Fan","family":"Chao","sequence":"first","affiliation":[{"name":"From Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (T.-F.C., J.-N.L., K.-L.W., Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-C.T., F.-P.C., S.-A.C.); Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan (T.-F.C., J.-N.L., K.-L.W., Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-C.T., F.-P.C., S.-A.C.); Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (C.-J.L.);..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Jen","family":"Liu","sequence":"additional","affiliation":[{"name":"From Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (T.-F.C., J.-N.L., K.-L.W., Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-C.T., F.-P.C., S.-A.C.); Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan (T.-F.C., J.-N.L., K.-L.W., Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-C.T., F.-P.C., S.-A.C.); Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (C.-J.L.);..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo-Nan","family":"Liao","sequence":"additional","affiliation":[{"name":"From Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (T.-F.C., J.-N.L., K.-L.W., Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-C.T., F.-P.C., S.-A.C.); Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan (T.-F.C., J.-N.L., K.-L.W., Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-C.T., F.-P.C., S.-A.C.); Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (C.-J.L.);..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kang-Ling","family":"Wang","sequence":"additional","affiliation":[{"name":"From Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (T.-F.C., J.-N.L., K.-L.W., Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-C.T., F.-P.C., S.-A.C.); Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan (T.-F.C., J.-N.L., K.-L.W., Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-C.T., F.-P.C., S.-A.C.); Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (C.-J.L.);..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yenn-Jiang","family":"Lin","sequence":"additional","affiliation":[{"name":"From Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (T.-F.C., J.-N.L., K.-L.W., Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-C.T., F.-P.C., S.-A.C.); Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan (T.-F.C., J.-N.L., K.-L.W., Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-C.T., F.-P.C., S.-A.C.); Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (C.-J.L.);..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih-Lin","family":"Chang","sequence":"additional","affiliation":[{"name":"From Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (T.-F.C., J.-N.L., K.-L.W., Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-C.T., F.-P.C., S.-A.C.); Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan (T.-F.C., J.-N.L., K.-L.W., Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-C.T., F.-P.C., S.-A.C.); Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (C.-J.L.);..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Wei","family":"Lo","sequence":"additional","affiliation":[{"name":"From Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (T.-F.C., J.-N.L., K.-L.W., Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-C.T., F.-P.C., S.-A.C.); Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan (T.-F.C., J.-N.L., K.-L.W., Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-C.T., F.-P.C., S.-A.C.); Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (C.-J.L.);..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Feng","family":"Hu","sequence":"additional","affiliation":[{"name":"From Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (T.-F.C., J.-N.L., K.-L.W., Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-C.T., F.-P.C., S.-A.C.); Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan (T.-F.C., J.-N.L., K.-L.W., Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-C.T., F.-P.C., S.-A.C.); Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (C.-J.L.);..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ta-Chuan","family":"Tuan","sequence":"additional","affiliation":[{"name":"From Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (T.-F.C., J.-N.L., K.-L.W., Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-C.T., F.-P.C., S.-A.C.); Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan (T.-F.C., J.-N.L., K.-L.W., Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-C.T., F.-P.C., S.-A.C.); Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (C.-J.L.);..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fa-Po","family":"Chung","sequence":"additional","affiliation":[{"name":"From Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (T.-F.C., J.-N.L., K.-L.W., Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-C.T., F.-P.C., S.-A.C.); Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan (T.-F.C., J.-N.L., K.-L.W., Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-C.T., F.-P.C., S.-A.C.); Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (C.-J.L.);..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzeng-Ji","family":"Chen","sequence":"additional","affiliation":[{"name":"From Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (T.-F.C., J.-N.L., K.-L.W., Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-C.T., F.-P.C., S.-A.C.); Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan (T.-F.C., J.-N.L., K.-L.W., Y.-J.L., S.-L.C., L.-W.L., Y.-F.H., T.-C.T., F.-P.C., S.-A.C.); Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (C.-J.L.);..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y. 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