Oral Anticoagulation following intracranial haemorrhage in patients with atrial fibrillation
Bibliographic record
Abstract
PURPOSE: To review the current evidence on anticoagulation for intracranial haemorrhage (ICrH) survivors with atrial fibrillation (AF). METHOD: Narrative review of the literature. FINDINGS: AF and ICrH are age-related conditions whose prevalence and comorbidity is expected to increase with the ageing population. Patients with ICrH were excluded from pivotal randomized trials of anticoagulation in AF and guidelines do not provide strong recommendations on if and when to (re)initiate anticoagulation in patients with AF and ICrH. Pooled analyses of phase II randomized trials have reported reduced risk of ischaemic major adverse cardiovascular events with anticoagulation in this population, but there remains uncertainty regarding the effects of anticoagulation on recurrent ICrH and death, as well as potential heterogeneity of treatment effect in higher risk subgroups, such as patients with cerebral amyloid angiopathy. There are no reported randomized trials investigating the optimal timing of anticoagulation (re)initiation in ICrH survivors with AF and the findings from observational studies have been inconsistent. CONCLUSION: Whether or not OAC should be resumed in ICrH survivors with AF and the optimal timing of OAC (re)initiation are challenging clinical dilemmas that are becoming more frequent with our ageing population. The existing prevalence of AF in patients with ICrH and changing global demographics highlight the importance of ongoing and future randomized trials addressing unresolved questions surrounding optimal stroke prevention strategies in this vulnerable patient population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".