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Oral anticoagulants status after acute ischemic stroke and prognosis in patients with atrial fibrillation.
Wu, Xiaoyu; Xu, Yue; Wei, Meng; Li, Mengmeng; Lei, Xiangyu; Yuan, Huijie; Guo, Jing; Zhang, Qiang; Zhang, Xiao; Sun, Man; Fan, Tong; Luo, Guogang.
Afiliación
  • Wu X; Stroke Centre and Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an 710061, China; Atrial Fibrillation Centre and Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Ro
  • Xu Y; Department of Neurology, Ninth hospital of Xi'an, No. 151 East Section of South Second Ring Road, Xi'an 710054, China.
  • Wei M; Stroke Centre and Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an 710061, China.
  • Li M; Stroke Centre and Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an 710061, China.
  • Lei X; Stroke Centre and Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an 710061, China.
  • Yuan H; Stroke Centre and Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an 710061, China.
  • Guo J; Department of Rehabilitation Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, No.55 Xingshansi West Street, Xi'an 710061, China.
  • Zhang Q; Department of Neurology, Shaanxi Provincial People's Hospital, No. 256 Youyi West Road, Xi'an 710068, China.
  • Zhang X; Department of Neurology, Xijing Hospital of Air Force Military Medical University, No. 127 Changle West Road, Xi'an 710032, China.
  • Sun M; Department of Neurology, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 Xiwu Road, Xi'an 710004, China.
  • Fan T; Department of Neurology, Xi'an Gaoxin Hospital, No. 16 Tuanjie South Road, Xi'an 710075, China.
  • Luo G; Stroke Centre and Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an 710061, China. Electronic address: lilyxiaoyu0204@stu.xjtu.edu.cn.
J Stroke Cerebrovasc Dis ; 33(1): 107452, 2024 Jan.
Article en En | MEDLINE | ID: mdl-37931484
OBJECTIVES: To investigate the oral anticoagulants (OACs) use after acute ischemic stroke (AIS) and prognosis of patients with atrial fibrillation (AF). METHODS: This was a real-world follow-up research of AIS patients with AF admitted to 5 hospitals in northwestern China. We visited these individuals every 6 months to check the type, dosage of OACs, and to record IS recurrence, bleeding, and death events and modified Rankin Scale (mRS) scores until December 2022. When one of the following occurring first was endpoint: IS recurrence, death or study end. Patients were divided into continuous anticoagulation group and non-continuous anticoagulation group based on whether they continued to take OACs from the moment they were discharged until the endpoint. We further analyzed the association between anticoagulation persistence and outcomes. RESULTS: Among all 250 patients with OACs indication, 147 patients (58.8 %) received OACs at discharge. Only 37.9 % of patients (39/103) started OACs after discharge. Of the 147 patients treated with OACs, 21.8 % (32/147) discontinued anticoagulation after discharge. 239 of the 250 patients had completed the median 40-month follow-up with 91 patients in continuous anticoagulation group and 148 patients in non-continuous anticoagulation group. In the multivariate COX regression, non-continuous anticoagulation was an independent risk factor for poor prognosis (mRS>2) in AIS patients with AF (1.452[1.011, 2.086], p = 0.043). CONCLUSIONS: This study revealed an upward trend in the use rate of OACs, but low OACs rates that meet guideline-based criteria and low anticoagulation persistence in AF patients after AIS in the northwestern China. Discontinuous anticoagulation was associated with an increased risk of poor prognosis in these patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / Accidente Cerebrovascular / Accidente Cerebrovascular Isquémico Límite: Humans Idioma: En Revista: J Stroke Cerebrovasc Dis Asunto de la revista: ANGIOLOGIA / CEREBRO Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / Accidente Cerebrovascular / Accidente Cerebrovascular Isquémico Límite: Humans Idioma: En Revista: J Stroke Cerebrovasc Dis Asunto de la revista: ANGIOLOGIA / CEREBRO Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos