Initiation of guideline-matched oral anticoagulant in atrial fibrillation-related stroke
- Authors
- Eun, M.-Y.; Kim, J.-Y.; Hwang, Y.-H.; Park, M.-S.; Kim, J.-T.; Choi, K.-H.; Jung, J.-M.; Yu, Sung wook; Kim, Chi Kyung; Oh, K.; Song, T.-J.; Kim, Y.-J.; Kim, B.J.; Heo, S.H.; Park, K.-Y.; Kim, J.-M.; Park, J.-H.; Choi, J.C.; Chung, J.-W.; Bang, O.Y.; Kim, G.-M.; Seo, W.-K.
- Issue Date
- Jan-2021
- Publisher
- Korean Stroke Society
- Keywords
- Anticoagulants; Atrial fibrillation; Guideline; Outcome; Stroke
- Citation
- Journal of Stroke, v.23, no.1, pp 113 - 123
- Pages
- 11
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- Journal of Stroke
- Volume
- 23
- Number
- 1
- Start Page
- 113
- End Page
- 123
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/51994
- DOI
- 10.5853/jos.2020.03440
- ISSN
- 2287-6391
2287-6405
- 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. © 2021 Korean Stroke Society.
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Collections - 2. Clinical Science > Department of Neurology > 1. Journal Articles
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