Initiation of guideline-matched oral anticoagulant in atrial fibrillation-related stroke

Mi Yeon Eun, Jae Young Kim, Yang Ha Hwang, Man Seok Park, Joon Tae Kim, Kang Ho Choi, Jin Man Jung, Sungwook Yu, Chi Kyung Kim, Kyungmi Oh, Tae Jin Song, Yong Jae Kim, Bum Joon Kim, Sung Hyuk Heo, Kwang Yeol Park, Jeong Min Kim, Jong Ho Park, Jay Chol Choi, Jong Won Chung, Oh Young BangGyeong Moon Kim, Woo Keun Seo

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)113-123
Number of pages11
JournalJournal of Stroke
Volume23
Issue number1
DOIs
StatePublished - 2021

Keywords

  • Anticoagulants
  • Atrial fibrillation
  • Guideline
  • Outcome
  • Stroke

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