Clinical features of intracerebral hemorrhage under antithrombotic therapy in the warfarin era

We investigated the clinical characteristics and prognosis of intracerebral hemorrhage (ICH) under antithrombotic therapy. We retrospectively reviewed the medical records of 463 patients admitted to our hospital due to ICH during 3-year periiod between January 2010 and December 2012. The ICH patients were classified into 4 groups: patients with anticoagulant therapy (AC, n = 36). antiplatelet therapy (AP, n = 65), anticoagulant and antiplatelet therapies (AC+AP, n = 18), and no antiplatelet or anticoagulant therapy (NT, n=344). There were no significant differences between the groups in terms of gender, hematoma location, and initial hematoma size. Age and previous history of ischemic cerebral disease or ischemic coronary disease were significantly higher in the AC. AP, and AC+AP groups than in the NT group. The number of patients who had received previous treatment for hypertension was higher in the AC, AP, and AC+AP groups, and systolic blood pressure at admission was lower in the AC and AC+AP groups than in the NT group. Hematoma enlargement occurred more frequently in the AC and AC+AP groups. The AC, AP and AC+AP groups showed worse prognosis and higher mortality than the NT group. Anticoagulant therapy can be a risk factor for hematoma enlargement, and anticoagulant and/or antiplatelet therapy can be a risk factor of poor outcome.