CARDIOEMBOLIC STROKE IN LATVIA : PREVENTION AND LONG-TERM OUTCOME

Abstract

NTRODUCTION:Untreated non-valvular atrial fibrillation is one of major causes of stroke. The goalof the study was to evaluate the use of antithrombotic medication stroke prevention and assess long-term stroke outcome.METHODS:This study involved 531 cardio embolicstroke patients of thePaul’sStradins Clinical University Hospital, Riga, Latvia,in 2014. After dischargethe patients or their relatives were interviewed by phone after 30, 90, 180, and 365 days. Standardized questions were asked about the patients’abilities and use of prescribed secondary prevention medication. Theresults were compared between patient groups, assigned according to prescribed medications. RESULTS:Of all the patients included in the study,8.9% were using oral anticoagulants before stroke onset. One year after discharge,1.44% of patients were not using any preventivemedication, 23.56%were using antiplatelet agents, 43.27% warfarin,and 31.73% target-specificoralanticoagulants. The one-year mortality ratewas 40.7%. The mortality rate was significantly higher in the patient group using no secondary preventivemedication or antiplatelet agents compared to the patient group that used oral anticoagulants. CONCLUSION:Cardio embolicstroke primary and secondary prevention in Latvia islacking. The study outcomes suggest that action is neededto increase the use of oral anticoagulants in primary stroke prevention in patients with atrial fibrillation. Poor function outcomes, dementia,and patients’incompliance limits the use of oral anticoagulants in secondary prevention