Association of intracranial hemorrhage risk with NOAC use vs. aspirin use

Researchers examined five clinical studies that compared the risk of intracranial hemorrhage from non-vitamin K antagonist oral anticoagulant (NOAC) use with the risk of intracranial hemorrhage from aspirin use.

Researchers examined five clinical studies that compared the risk of intracranial hemorrhage from non-vitamin K antagonist oral anticoagulant (NOAC) use with the risk of intracranial hemorrhage from aspirin use. The team, representing the United States and Taiwan, theorized that the risk would be elevated with NOACs; and they appear to have been at least partially right. Based on outcomes from more than 39,000 patients, intake of 15–20 mg of rivaroxaban per day was linked to a significantly higher risk of intracranial hemorrhage compared with aspirin. However, 10 mg of rivaroxaban daily, 5 mg of rivaroxaban twice daily, or 5 mg of apixaban twice daily did not have the same effect. The findings of the systematic review and meta analysis suggest that the increased risk from NOACs is dose-dependent and should be studied further as prophylaxis against stroke in patients who do not have atrial fibrillation but who do have potential sources of cardiac emboli.