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For people with atrial fibrillation (AFib), an irregular heartbeat, and intracranial hemorrhage, a type of stroke also known as a brain bleed, anticoagulant use was associated with a lower risk of ischemic stroke and death, according to a new study published in Neurology. The study also found no increased risk of more brain bleeds when people took newer anticoagulants.

Anticoagulants are drugs that stop the blood from clotting easily. Ischemic stroke is when blood flow is blocked, often by a blood clot, to part of the brain.

While newer anticoagulants were not associated with an increased risk of future brain bleeds, warfarin, an older anticoagulant, was. Newer anticoagulants, called direct oral anticoagulants, include apixaban, rivaroxaban, edoxaban and dabigatran.

Because this was an observational study, the findings do not show that anticoagulants caused these differences in risk, only that they were associated with them.

"Anticoagulants can help prevent ischemic stroke, but for people with atrial fibrillation who have had a previous brain bleed, treatment decisions can be complex due to concern about the possibility of another brain bleed," said Paula Tiili, M.D., of the University of Helsinki in Finland.

"For our study, we wanted to better understand the risks of ischemic stroke and brain bleeds in people using newer and older anticoagulants."

The study included 1,502 people with an average age of 78 who had AFib and brain bleeds that occurred at least four months prior to their AFib diagnosis.

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