Warfarin Use and Risk of Intracerebral Hemorrhage and Bleeding in Atrial Fibrillation Patients

Warfarin is a widely used oral anticoagulant for stroke prevention in patients with atrial fibrillation, but its safety profile is complicated by the risk of bleeding, particularly in individuals with uncontrolled hypertension. This study investigated the relationship between warfarin use and clinical outcomes including bleeding, thromboembolic events, and mortality in a cohort of 750 atrial fibrillation patients. Patients were retrospectively categorized based on warfarin exposure and systolic blood pressure levels. Statistical analyses included logistic regression, survival analysis, and subgroup comparisons. Although bleeding events occurred more frequently among warfarin users compared to non-users, the difference was not statistically significant. Similarly, warfarin use was not associated with increased mortality or worse survival outcomes. However, stratified analysis revealed a higher incidence of bleeding among patients with elevated systolic blood pressure receiving warfarin, suggesting a potential interaction between anticoagulation and hypertensive status. These findings emphasize the need for individualized risk assessment and careful blood pressure management when initiating warfarin therapy in atrial fibrillation patients.