Patients with AF (atrial fibrillation) and acute ischaemic stroke receive diverse treatments. Vitamin K antagonists(VKA) and oral anticoagulants are used widely, and they affect stroke severity and blood clot breakdown. This study looks at these associations, along with the safety concerns and 3-month outcomes of treatment modalities.
The objective is to associate effective therapies with brain stroke and heart irregularity. A consecutive cohort group of 8179 patients with AF was studied from 2013-19. About 49% were women with 1486 on VKA therapy, and 1634 or 20% were on DOAC treatment at stroke onset. There were 5059 control subjects as well. The anticoagulant use vs. no control groups was compared. The parameters include stroke severity, rates of IVT/MT, sICH, and favorable outcomes (mRS 0 -2) at three months.
Stroke severity was reduced in the DOAC group when compared to VKA and control subjects. The IVT rate was lower in 63% of eligible VKA patients or 156 out of 247. It was significantly lower in DOAC patients (15%) than controls (74%). Whereas, sICH after IVT in controls, VKA, and DOAC subjects was 3.6%, 4.6%, and 3.1%, respectively. Adjustments were made to prognostic confounders.
Prior DOAC therapy in AF patients reduced stroke severity. The 3-month outcome was favorable, while IVT rate was also remarkably low. Further research can reduce IVT restrictions on them.
Ref: https://onlinelibrary.wiley.com/doi/10.1002/ana.25917
