The American Journal of Medicine
Volume 118, Issue 6 , Pages 612-617 , June 2005

Incidence of intracranial hemorrhage in patients with atrial fibrillation who are prone to fall

  • Brian F. Gage, MD, MSc

      Affiliations

    • Division of General Medical Sciences, Washington University School of Medicine, St. Louis, MO
    • Corresponding Author InformationRequests for reprints should be sent to: Brian F. Gage, MD, MSc, Division of General Medical Sciences, Washington University School of Medicine Campus Box 8005, 660 S. Euclid Ave., St. Louis, MO 63110
    • ,
  • Elena Birman-Deych, MS

      Affiliations

    • Division of General Medical Sciences, Washington University School of Medicine, St. Louis, MO
    • ,
  • Roger Kerzner, MD

      Affiliations

    • Division of Cardiology, Washington University School of Medicine, St. Louis, Missouri
    • ,
  • Martha J. Radford, MD

      Affiliations

    • Center for Outcomes Research and Evaluation at Yale New Haven Health System, and Division of Cardiology, Yale School of Medicine, New Haven, Connecticut 06504
    • ,
  • David S. Nilasena, MD, MSPH, MS

      Affiliations

    • Centers for Medicare and Medicaid Services, Dallas, Texas 75202
    • ,
  • Michael W. Rich, MD

      Affiliations

    • Division of Cardiology, Washington University School of Medicine, St. Louis, Missouri

References 

  1. Van Walraven C , Hart RG , Singer DE , et al.   Oral anticoagulants vs aspirin in nonvalvular atrial fibrillation (an individual patient meta-analysis) . JAMA . 2002;288:2441–2448
  2. Olsson SB  Executive Steering Committee on behalf of the SPORTIF III Investigators . Stroke prevention with the oral direct thrombin inhibitor ximelagatran compared with warfarin in patients with non-valvular atrial fibrillation (SPORTIF III) (randomized controlled trial) . Lancet . 2003;362:1691–1698
  3. Albers GW , Diener HC , Frison L , et al.   Ximelagatran vs warfarin for stroke prevention in patients with nonvalvular atrial fibrillation (a randomized trial) . JAMA . 2005;293:690–698
  4. The Boston Area Anticoagulation Trial for Atrial Fibrillation Investigators . The effect of low-dose warfarin on the risk of stroke in patients with nonrheumatic atrial fibrillation . N Engl J Med. . 1990;323:1505–1511
  5. Connolly SJ . Canadian Atrial Fibrillation Anticoagulation (CAFA) Study . J Am Coll Cardiol. . 1991;18:349–355
  6. Stroke Prevention in Atrial Fibrillation Investigators . Stroke Prevention in Atrial Fibrillation (SPAF) Study. Final results . Circulation . 1991;84:527–539
  7. Stroke Prevention Atrial Fibrillation III Writing Committee . Patients with nonvalvular atrial fibrillation at low risk of stroke during treatment with aspirin (Stroke Prevention in Atrial Fibrillation III Study) . JAMA . 1998;279:1273–1277
  8. Gulløv AL , Koefoed BG , Petersen P , et al.   Fixed minidose warfarin and aspirin alone and in combination vs adjusted-dose warfarin for stroke prevention in atrial fibrillation (Second Copenhagen Atrial Fibrillation, Aspirin, and Anticoagulation Study) . Arch Intern Med. . 1998;158:1513–1521
  9. Pengo V , Zasso A , Barbero F , et al.   Effectiveness of fixed minidose warfarin in the prevention of thromboembolism and vascular death in nonrheumatic atrial fibrillation . Am J Cardiol. . 1998;82:433–437
  10. Hellemons BS , Langenberg M , Lodder J , et al.   Primary prevention of arterial thromboembolism in non-rheumatic atrial fibrillation in primary care (randomized controlled trial comparing two intensities of coumarin with aspirin) . BMJ . 1999;319:958–964
  11. Monette J , Gurwitz JH , Rochon PA , Avorn J . Physician attitudes concerning warfarin for stroke prevention in atrial fibrillation (results of a survey of long-term care practitioners) . J Am Geriatr Soc. . 1997;45:1060–1065
  12. Weisbord SD , Whittle J , Brooks RC . Is warfarin really underused in patients with atrial fibrillation? . J Gen Intern Med. . 2001;16:743–749
  13. Go AS , Hylek EM , Borowsky LH , et al.   Warfarin use among ambulatory patients with nonvalvular atrial fibrillation (the anticoagulation and risk factors in atrial fibrillation (ATRIA) study) . Ann Intern Med. . 1999;131:927–934
  14. White RH , Beyth RJ , Zhou H , Romano PS . Major bleeding after hospitalization for deep-venous thrombosis . Am J Med. . 1999;107:414–424
  15. He J , Whelton PK , Vu B , Klag MJ . Aspirin and risk of hemorrhagic stroke (a meta-analysis of randomized controlled trials) . JAMA . 1998;280:1930–1935
  16. Rosand J , Eckman MH , Knudsen KA , et al.   The effect of warfarin and intensity of anticoagulation on outcome of intracerebral hemorrhage . Arch Intern Med. . 2004;164:880–884
  17. Birman-Deych E , Waterman AD , Yan Y , et al.   Accuracy of ICD-9 codes for identifying stroke and cardiovascular risk factors . Med Care . 2005;43:480–485
  18. Gage BF , Waterman AD , Shannon W , et al.   Validation of clinical classification schemes for predicting stroke (results from the National Registry of Atrial Fibrillation) . JAMA . 2001;285:2864–2870
  19. Gage BF , van Walraven C , Pearce L , et al.   Validation of stroke-risk stratification schemes . Circulation . 2004;110:2287–2292
  20. Hart RG , Halperin JL , Pearce AC , et al.   Lessons from the stroke prevention in atrial fibrillation trials . Ann Intern Med. . 2003;138:831–838
  21. Lord SR , Castell S , Corcoran J , et al.   The effect of group exercise on physical functioning and falls in frail older people living in retirement villages (a randomized, controlled trial) . J Am Geriatr Soc. . 2003;51:1685–1692
  22. Bischoff-Ferrari HA , Dawson-Hughes B , Willett WC , et al.   Effect of vitamin D on falls (a meta-analysis) . JAMA . 2004;291:1999–2006
  23. Jensen J , Lundin-Olsson L , Nyberg L , Gustafson Y . Fall and injury prevention in older people living in residential care facilities. a cluster randomized trial . Ann Intern Med. . 2002;136:733–741
  24. Kallin K , Lundin-Olsson L , Jensen J , et al.   Predisposing and precipitating factors for falls among older people in residential care . Public Health . 2002;116:263–271
  25. Tinetti ME . Clinical practice (preventing falls in elderly persons) . N Engl J Med. . 2003;348:42–49
  26. Woo D , Sauerbeck LR , Kissela BM , et al.   Genetic and environmental risk factors for intracerebral hemorrhage (preliminary results of a population-based study) . Stroke . 2002;33:1190–1196 discussion, 1190–1196
  27. Berwaerts J , Webster J . Analysis of risk factors involved in oral-anticoagulant-related intracranial haemorrhages . Qjm. . 2000;93:513–521
  28. Saloheimo P , Juvela S , Hillbom M . Use of aspirin, epistaxis, and untreated hypertension as risk factors for primary intracerebral hemorrhage in middle-aged and elderly people . Stroke . 2001;32:399–404
  29. Bailey RD , Hart RG , Benavente O , Pearce LA . Recurrent brain hemorrhage is more frequent than ischemic stroke after intracranial hemorrhage . Neurology . 2001;56:773–777
  30. Nieuwenhuis HK , Albada J , Banga JD , Sixma JJ . Identification of risk factors for bleeding during treatment of acute venous thromboembolism with heparin or low molecular weight heparin . Blood . 1991;78:2337–2343
  31. Rubenstein LZ , Josephson KR , Robbins AS . Falls in the nursing home . Ann Intern Med. . 1994;121:442–451
  32. Rosand J , Hylek EM , O’Donnell HC , Greenberg SM . Warfarin-associated hemorrhage and cerebral amyloid angiopathy (a genetic and pathologic study) . Neurology . 2000;55:947–951
  33. O’Donnell HC , Rosand J , Knudsen KA , et al.   Apolipoprotein E genotype and the risk of recurrent lobar intracerebral hemorrhage . N Engl J Med. . 2000;342:240–245
  34. McCarron MO , Nicoll JA , Ironside JW , et al.   Cerebral amyloid angiopathy-related hemorrhage (interaction of APOE epsilon2 with putative clinical risk factors) . Stroke . 1999;30:1643–1646
  35. Li J , Brown J , Levine M . Mild head injury, anticoagulants, and risk of intracranial injury . Lancet . 2001;357:771–772
  36. Karni A , Holtzman R , Bass T , et al.   Traumatic head injury in the anticoagulated elderly patient (a lethal combination) . Am Surg. . 2001;67:1098–1100
  37. Fang MC , Chang Y , Hylek EM , et al.   Advanced age, anticoagulation intensity, and risk for intracranial hemorrhage among patients taking warfarin for atrial fibrillation . Ann Intern Med. . 2004;141::745–752

 Grant Support: Supported by the American Heart Association (0270099N). Disclaimer: The conclusions presented are solely those of the authors and do not represent those of the Quality Improvement Organizations, American Heart Association, or CMS. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of commercial products imply endorsement of them by the U. S. Government. The authors assume full responsibility for the accuracy and completeness of the ideas presented.

PII: S0002-9343(05)00141-5

doi: 10.1016/j.amjmed.2005.02.022

The American Journal of Medicine
Volume 118, Issue 6 , Pages 612-617 , June 2005

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