Background and Purpose To evaluate the outcome events and bleeding complications of the European Society of Cardiology (ESC) guideline-matched oral anticoagulant therapy for patients with acute ischemic stroke and atrial fibrillation (AF). Methods Patients with acute ischemic stroke and AF from a nationwide multicenter registry (Kore-an ATrial fibrillaTion EvaluatioN regisTry in Ischemic strOke patieNts [K-ATTENTION]) between January 2013 and December 2015 were included in the study. Patients were divided into the ESC guide-line-matched and the non-matched groups. The primary outcome was recurrence of any stroke during the 90-day follow-up period. Secondary outcomes were major adverse cerebrovascular and cardiovascular events, ischemic stroke, intracranial hemorrhage, acute coronary syndrome, all-cause mortality, and major hemorrhage. Propensity score matching and logistic regression analyses were performed to assess the effect of the treatments administered. Results Among 2,321 eligible patients, 1,126 patients were 1:1 matched to the ESC guideline-matched and the non-matched groups. As compared with the non-matched group, the ESC guide-line-matched group had a lower risk of any recurrent stroke (1.4% vs. 3.4%; odds ratio [OR], 0.41; 95% confidence interval [CI], 0.18 to 0.95). The risk of recurrent ischemic stroke was lower in the ESC guideline-matched group than in the non-matched group (0.9% vs. 2.7%; OR, 0.32; 95% CI, 0.11 to 0.88). There was no significant difference in the other secondary outcomes between the two groups. Conclusions ESC guideline-matched oral anticoagulant therapy was associated with reduced risks of any stroke and ischemic stroke as compared with the non-matched therapy.
Bibliographical noteFunding Information:
This study was supported by the National Research Foundation of Korea and funded by the Ministry of Education (2019R1A2C 2008788).
Woo-Keun Seo received honoraria for lectures from Pfizer, Sanofi-Aventis, Otsuka Korea, Dong-A Pharmaceutical Co. Ltd., Bayer, Daewoong Pharmaceutical Co. Ltd., Daiichi Sankyo Korea Co. Ltd., and Boryung Pharmaceutical; study grants from Dai-ichi Sankyo Korea Co. Ltd.; a consulting fee from OBELAB Inc.; and stock option from JLK Inspection. The others have no financial conflicts of interest.
© 2021 Korean Stroke Society.
- Atrial fibrillation