Hemorrhagic Coagulation Disorders and Ischemic Stroke: How to Reconcile Both?

Round 1

Reviewer 1 Report

Dear Author thank you for giving me the opportunity to read this interesting review.

I have some issues that I would like you to review:

lines 42-45: please better specify the results of RE-LY trial;

I think it would be appropriate to include a short paragraph on strokes (both) related with COVID-19 infection. If you believe appropriate, please consider this review: Brain Hemorrhages. 2022 Mar;3(1):29-35. doi: 10.1016/j.hest.2021.12.002. 

I suggest to include a table with risk factors for ischemic and hemorrhagic strokes in two distinct columns with a third one that contains possible solutions to balance the risk. I hope you agree with reviewer.

Considering that this narrative review is quite long, I suggest to shorten about 15-20%. There are some repeated messages in the paragraphs within the text. 

Best regards

None

Author Response

POINT BY POINT REVIEWER 1

lines 42-45: please better specify the results of RE-LY trial;

According to the Reviewers suggestion, the results of RE-LY trial have been better specified

I think it would be appropriate to include a short paragraph on strokes (both) related with COVID-19 infection. If you believe appropriate, please consider this review: Brain Hemorrhages. 2022 Mar;3(1):29-35. doi: 10.1016/j.hest.2021.12.002.

According to the suggestion of the reviewer, a short paragraph on strokes (both) related with COVID-19 infection has been added

I suggest to include a table with risk factors for ischemic and hemorrhagic strokes in two distinct columns with a third one that contains possible solutions to balance the risk. I hope you agree with reviewer.

According with the reviewer's suggestion a table has been added

Considering that this narrative review is quite long, I suggest to shorten about 15-20%. There are some repeated messages in the paragraphs within the text.

According to the suggestion of the reviewer the review has been shortened

Author Response File: Author Response.pdf

Reviewer 2 Report

Dear authors, I'm pleased to read this review paper.

The topic is very interesting and actual. The exact reintroduction or introduction time to NOAC in a patient with recent ischemic stroke and high risk of bleeding or cerebral haemorrhagic stroke is debated.

I think that this paper is well prganized in general, but I some suggestions;

The background is too long. Please cut a part of the introduction and add a section entitled " the new oral anticoagulant drugs and bleeding risk in patients with ischemic stroke".

The figures are clear. I suggest to add a table with the suggest timiline for starting NAO in patients with major bleeding risk and ischemic stroke and another with timeline for NAO reintroduction in patients with ischemic stroke and bleeding

The english style could be improved.

The paper lack in discussion with author's  thought.

The english style could be improved. 

Author Response

POINT BY POINT REVIEWER 2

The background is too long. Please cut a part of the introduction and add a section entitled "The new oral anticoagulant drugs and bleeding risk in patients with ischemic stroke".

According to the suggestion of the Reviewer, the background has been shortened and the title has been modified

The figures are clear. I suggest to add a table with the suggest timeline for starting NAO in patients with major bleeding risk and ischemic stroke and another with timeline for NAO reintroduction in patients with ischemic stroke and bleeding

According to the suggestion of the Reviewer two tables are added in the text The English style could be improved.

In accordance with the reviewer's suggestions, the text will be revised in English upon proofreading if it is published.

The paper lack in discussion with author's thought.

The review performed was intended to be only an analysis of the available literature without personal judgments or direct observations

Author Response File: Author Response.pdf

Reviewer 3 Report

Interesting title and introduction, I was really curious about the conclusions of the publication. An impressive number of references.

I have few comments:

1. There is no diagram/description of what hemorrhagic coagulation disorders will be included in the manuscript. 

2. In my opinion, the work is not systematized - it is difficult to find specific information regarding what clinical situation and what therapy would be recommende. Maybe a summary/table would be useful?

3. The conclusions are too general.

Author Response

REVIEWER 3 POINT BY POINT

1. There is no diagram/description of what hemorrhagic coagulation disorders will be included in the manuscript.

According to the suggestion of the Reviewer, a description of coagulative disorders discussed in the review is added in the text

2. In my opinion, the work is not systematized - it is difficult to find specific information regarding what clinical situation and what therapy would be recommended. Maybe a summary/table would be useful?

According to the suggestion of the Reviewer, a table has been added to the text

3. The conclusions are too general.

According to the suggestion of the Reviewer, the conclusions are more specified.

Author Response File: Author Response.pdf

Round 2

Reviewer 2 Report

the authors made the requested changes

Reviewer 3 Report

I have no further comments