Letter by Nielsen and Johnsen Regarding Article, “Optimal Timing of Anticoagulant Treatment After Intracerebral Hemorrhage in Patients With Atrial Fibrillation”
To the Editor:
We read with great interest the study by Pennlert et al.1 Using data from the Swedish registries, the authors provided evidence to the clinical treatment conundrum: should atrial fibrillation patients who suffer an intracranial hemorrhage (ICH) receive anticoagulant treatment. As referenced by the authors, we have previously published similar data and observed associations trending in the same direction, that is, patients who received warfarin treatment have a lower rate of death and thromboembolic events in comparison with those unexposed to warfarin.2,3 In addition, we observed no clear relationship of higher recurrent ICH events under warfarin treatment.
Observational data examining ICH survivors are of clinical interest; however, we warrant caution in overinterpretation of the obtained results given the nature of the observational study design. Pennlert …