Anticoagulants, Reperfusion Therapy, and Outcomes in Ischemic Stroke Patients With Non-Valvular Atrial Fibrillation - A Single-Center, 6-Year Experience of 546 Consecutive Patients

Circulation Journal : Official Journal of the Japanese Circulation Society
Satoshi SudaKazumi Kimura

Abstract

This study investigated changes in anticoagulant use, treatment, and functional outcomes in acute ischemic stroke (AIS) patients with non-valvular atrial fibrillation (NVAF) over a 6-year period. Methods and Results: Patients with AIS and NVAF admitted to our department from April 2011 to March 2017 were analyzed retrospectively. Patients were divided into 3 groups based on the time of the initial visit (Periods 1-3, corresponding to April 2011-March 2013, April 2013-March 2015, and April 2015-March 2017, respectively). Associations between prescribed medication prior to event and stroke severity, reperfusion therapy, and outcomes were assessed. There was no significant change in the rate of insufficient warfarin and inappropriately lowered doses of direct oral anticoagulant (DOAC) treatment over time. The number of patients receiving prior DOAC treatment increased, but neurological severity on admission was milder than in the other 2 groups. The rate of reperfusion therapy increased from 19.9% (Period 1) to 42.7% (Period 3) for moderate-to-severe stroke patients. Multivariate logistic regression analysis revealed that reperfusion therapy was independently positively associated with good functional outcomes, but negatively asso...Continue Reading

References

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Citations

Sep 7, 2018·Circulation Journal : Official Journal of the Japanese Circulation Society·Masatoshi Koga
Nov 5, 2019·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Satoshi SudaKazumi Kimura
Jun 14, 2021·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Makoto NakajimaYukio Ando

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