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Title: Warfarin Linked to Increased Bleeding in Brain, Death in Haemorrhagic Stroke Patients
URL: http://www.pslgroup.com/dg/22DE92.htm
Doctor's Guide
September 30, 2008

ST. PAUL, Minn -- September 30, 2008 -- Patients taking warfarin may have larger amounts of bleeding in the brain and increased risk of death if they suffer a haemorrhagic stroke, according to a study published in the September 30 issue of Neurology.

The study involved 258 people who had brain haemorrhage, 51 of whom were taking warfarin. Participants were aged 69 years on average and lived in or near Cincinnati, Ohio. The group underwent brain scans to confirm the type of stroke. The brain scans were used to measure the size of the blood clots.

The study found that people who took warfarin and suffered a brain haemorrhage while their international normalised ratio (INR) was above 3 had about twice as much initial bleeding as those not taking warfarin. However, this effect was not seen in people whose blood was more likely to clot as determined by an INR of less than 3.

"Warfarin is very effective for preventing ischaemic strokes among people with atrial fibrillation and for most patients with this condition, it is the right choice," said study author Matthew L. Flaherty, MD, University of Cincinnati, Cincinnati, Ohio.

"However, people who have bleeding into the brain while taking warfarin are at greater risk of dying than other people with haemorrhagic stroke. Our study may help to explain why. Fortunately, we did not see larger blood clots in people with an INR of less than 3."

"This shows the importance of good monitoring and adjustment of warfarin dose. People should talk to their doctors about the proper management of warfarin and learn the signs of stroke so they can get to an emergency room immediately if a stroke occurs," he said.

SOURCE: American Academy of Neurology

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