Risk of vitamin K antagonists in cases of cerebral microbleeds
- Cerebral microbleeds are associated with a higher risk of intracerebral hemorrhage.- When microbleeds are detected, the possible underlying pathology should be considered; this includes cerebral amyloid angiopathy and other factors that increase the risk of haemorrhage, particularly hypertension. - No randomised trials have yet been conducted into haemorrhagic complications and cerebral infarctions in patients with microbleeds who take vitamin K antagonists. This means that it is not clear whether the intended prevention of cerebral infarctions outweighs the increased risk of haemorrhage associated with use of vitamin K antagonists by these patients.- When deciding whether or not an older patient should be given anticoagulants the following should be taken into consideration as well: comorbidities, polypharmacy, the risk of falls and the probability that the patient can be optimally titrated to vitamin K antagonists. - If there is an increased risk of intracerebral haemorrhage but anticoagulants are indicated, direct oral anticoagulants (DOACs) might be preferable to vitamin K antagonists in patients with a history of cerebral microbleeds.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2018 |
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| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:162 |
|---|---|
| Enthalten in: |
Nederlands tijdschrift voor geneeskunde - 162(2018) vom: 26., Seite D1790 |
| Sprache: |
Niederländisch |
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| Weiterer Titel: |
Risico’s van vitamine K-antagonisten bij cerebrale microbloedingen |
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| Beteiligte Personen: |
Verhaar, B J H [VerfasserIn] |
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| Themen: |
12001-79-5 |
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| Anmerkungen: |
Date Completed 20.12.2018 Date Revised 20.12.2018 published: Print Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM280835124 |
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| 520 | |a - Cerebral microbleeds are associated with a higher risk of intracerebral hemorrhage.- When microbleeds are detected, the possible underlying pathology should be considered; this includes cerebral amyloid angiopathy and other factors that increase the risk of haemorrhage, particularly hypertension. - No randomised trials have yet been conducted into haemorrhagic complications and cerebral infarctions in patients with microbleeds who take vitamin K antagonists. This means that it is not clear whether the intended prevention of cerebral infarctions outweighs the increased risk of haemorrhage associated with use of vitamin K antagonists by these patients.- When deciding whether or not an older patient should be given anticoagulants the following should be taken into consideration as well: comorbidities, polypharmacy, the risk of falls and the probability that the patient can be optimally titrated to vitamin K antagonists. - If there is an increased risk of intracerebral haemorrhage but anticoagulants are indicated, direct oral anticoagulants (DOACs) might be preferable to vitamin K antagonists in patients with a history of cerebral microbleeds | ||
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