ArticleJournal of the American Heart Association2026
Timing of Antithrombotic Therapy Among Patients With Hemorrhagic Transformation After an Ischemic Stroke.
Article in Journal of the American Heart Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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25 authors.
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Abstract
backgroundEvidence to guide the optimal timing of antiplatelet and oral anticoagulants (OACs) therapy after hemorrhagic infarction (HI) versus parenchymal hematoma (PH) is limited and inconsistent, leading to substantial variation in practice. This study's goal was to study the practice pattern and compare clinical outcomes associated with early-versus-delayed initiation of antiplatelet/OACs after hemorrhagic transformation (HT).
methodsThis multicenter, retrospective, cross-sectional study included patients with acute ischemic stroke and HT. Patients with an HI or PH were categorized by HT to antithrombotic initiation time, and their outcomes-30-day HT exacerbation, composite outcomes of recurrent stroke/systemic emboli, 90-day vascular death, and functional outcomes-were compared.
resultsOf 748 patients, 496 received antiplatelets, and 252 received OACs after HT. The median HT-to-antiplatelet time was significantly shorter after HI than PH (1 [interquartile range, 0-2] versus 3 [interquartile range, 1-5] days;
conclusionsOur study found no statistically significant difference in HT exacerbation between early and late initiation of antiplatelets or OACs among patients with HI/PH, while prolonged delay among patients with PH were accompanied by increased systemic thromboembolic events. Although these findings offer preliminary clinical insight, prospective studies are needed.
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