Grant: Travel Awards - Institute Community Support

Atrial fibrillation is a common heart condition that increases the chance of stroke in elderly individuals, and this can be prevented through anticoagulation, or blood-thinning. However, blood-thinning increases risks of bleeding, including bleeds inside the brain. While newly approved drugs over the past 6 years have expanded options for blood-thinner treatment with lower risks of brain bleeds, no studies have evaluated the benefit-risk tradeoff of restarting blood-thinners among patients who suffered a brain bleed, especially those with high risks of developing a clot in the brain. The purpose of this study was to find out 1) what are the perspectives of clinicians on restarting blood-thinners to prevent clots in the brain among patients who suffered brain bleeds, and 2) if they were comfortable with restart a blood-thinner, how long after a brain bleed they preferred to restart them. We surveyed 228 clinicians from 3 international societies and found wide variability in practice patterns on whether blood-thinners should be restarted, and when they should occur after the initial brain bleed. We also found differences between specialties in their preferences for restarting blood-thinners. Together, our data support the dire need for high quality evidence in a clinical situation increasingly encountered by clinicians worldwide.