ESOC 2022 | Restarting antithrombotics after ICH

Daniela Poli, MD, Azienda Ospedaliera Universitaria Careggi, Florence, Italy, discusses the issues surrounding restarting antithrombotics after intracerebral hemorrhage (ICH). Antithrombotics are used for primary and secondary prevention of acute thrombosis and their use is indicated in a range of clinical conditions such as atrial fibrillation, cerebrovascular disease, and peripheral arterial disease. However, when patients receiving these therapies suffer an ICH, the decision to restart antithrombotics can be controversial. The risk of rebleeding must be balanced against the protection provided against thrombotic events. It has been seen in observational studies that the risk of recurrent ICH is high when restarting anticoagulants, but not as high as the risk of ischemic events in this population. A lack of high-quality data from randomized clinical trials leaves this clinical question unanswered. This interview took place at the ESOC 2022 congress in Lyon, France.