Is Anticoagulation Necessary for Severely Disabled Cardioembolic Stroke Survivors?

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dc.contributor.authorJurjāns, Kristaps
dc.contributor.authorVikmane, Baiba
dc.contributor.authorVētra (Jr), Jānis
dc.contributor.authorMiglāne, Evija
dc.contributor.authorKalējs, Oskars
dc.contributor.authorPriede, Zanda
dc.contributor.authorMillers, Andrejs
dc.contributor.institutionDepartment of Neurology and Neurosurgery
dc.contributor.institutionDepartment of Doctoral Studies
dc.contributor.institutionRīga Stradiņš University
dc.contributor.institutionDepartment of Internal Diseases
dc.date.accessioned2021-04-12T12:25:02Z
dc.date.available2021-04-12T12:25:02Z
dc.date.issued2019
dc.description.abstractBackground and Objectives: Oral anticoagulants are the hallmark of cardioembolic stroke prevention, but they are frequently underused, especially in elderly patients and patients with paroxysmal atrial fibrillation. In our paper, we analyzed the long-term outcome of severely disabled cardioembolic stroke survivors depending on the prescribed antithrombotic secondary prevention medication. Materials and Methods: In our study, we retrospectively collected data for ischemic stroke (IS) patients treated in P. Stradins Clinical University hospital, Riga, Latvia, from 2014 until 2017. Patients’ clinical data were collected using local stroke registry, including patients’ demographic data, vascular risk factors, clinical findings, and laboratory results. Severely disabled stroke survivors were followed up by phone at 30/90/180/365 days after discharge. Patients’ functional outcomes were assessed using the adapted version of The Rankin Focused Assessment–Ambulation. The collected data were compared in 4 groups according to prescribed secondary prevention medication. Results: A total of 682 (91.42%) patients were followed up and included in data analysis. The median age of patients was 80 (IQR = 75–85) years. Of these patients, 231 (31%) were males and 515 (69%) were females. One-year probability of survival of patients not taking any preventive medication was 53% (IQR = 29–76), while in patients taking antiplatelet agents it was 57% (IQR = 37–78), 78% (IQR = 68–88) of patients on Vitamin K antagonists (VKA) and 81% (IQR = 72–90) in patients on direct oral anticoagulants (DOACs). One year after discharge 73 (31%) had mRS 0–2, 50 (20.9%), 29 (12.1%) were still severely disabled, and 87 (36.4%) had died. Conclusions: Anticoagulant use in secondary prevention predicts better functional outcome and higher survival rate in patients with severe cardioembolic stroke due to non-valvular atrial fibrillation (NVAF), therefore severe neurological deficit must not be a reason of restriction of anticoagulatioen
dc.description.statusPeer reviewed
dc.format.extent1173100
dc.identifier.citationJurjāns, K, Vikmane, B, Vētra (Jr), J, Miglāne, E, Kalējs, O, Priede, Z & Millers, A 2019, 'Is Anticoagulation Necessary for Severely Disabled Cardioembolic Stroke Survivors?', Medicina (Kaunas), vol. 55, no. 9, 586. https://doi.org/10.3390/medicina55090586
dc.identifier.doi10.3390/medicina55090586
dc.identifier.issn1010-660X
dc.identifier.otherresearchoutputwizard: 64BF17D6-94BB-4C2E-8BD0-F69AEDD84858
dc.identifier.urihttps://dspace.rsu.lv/jspui/handle/123456789/3760
dc.language.isoeng
dc.relation.ispartofMedicina (Kaunas)
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectatrial fibrillation
dc.subjectcardioembolic stroke
dc.subjectstroke functional outcome
dc.subjectstroke mortality
dc.subject3.2 Clinical medicine
dc.subject1.1. Scientific article indexed in Web of Science and/or Scopus database
dc.titleIs Anticoagulation Necessary for Severely Disabled Cardioembolic Stroke Survivors?en
dc.type/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article

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