Naslov
IMPACT OF ANTICOAGULANT THERAPY ON THE OUTCOME OF ISCHEMIC STROKE IN PATIENTS WITH ATRIAL FIBRILLATION

Autori
Budinčević, Hrvoje ; Demarin, Vida

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
PhD Day 2014 - Abstract Book / - , 2014

Skup
PhD Day 2014

Mjesto i datum
Zagreb, Hrvatska, 23.05.2014

Vrsta sudjelovanja
Poster

Vrsta recenzije
Domaća recenzija

Ključne riječi
stroke; atrial fibrillation; anticoagulants

Sažetak
Introduction: Oral anticoagulant therapy has the leading role in ischemic stroke prevention in patients with atrial fibrillation, but its impact on clinical outcomes has not been clearly shown. The aim of this Ph.D. thesis was to investigate the impact of oral anticoagulant therapy on stroke outcomes. Materials and methods: The aim of this PhD thesis was to investigate the impact of oral anticoagulant therapy on stroke outcomes. This retrospective study included patients with atrial fibrillation who were hospitalized for ischemic stroke in the period from 1st January 2004 until 31st December 2010 at the University Hospital "Sveti Duh" in Zagreb. Patients were divided into three groups according to the prior antithrombotic therapy usage. The analysis of medical records included: demographic data, stroke risk factors, the stroke severity (assessed according to the National Institute of Health Stroke Scale), and the localization, size and the outcome (modified Rankin scale) of stroke. Data were analyzed using univariate and bivariate statistical analysis. Results: The study included 821 patients whose mean of age was 77.6± 8.2 years. Twenty-one per cent of patients received prior anticoagulant therapy, 30% of patients received prior antiplatelet therapy while 49% of patients were without prior antithrombotic therapy. Patients with prior anticoagulant therapy were the youngest (74.9±7.9, p<0.0001) among the three groups. These patients had more often previous ischemic strokes (42.8%, p<0.0001), hyperlipidemia (51.4%, p=0.0002) and chronic myocardial disease (77.5%, p<0.0001). Patients without prior antithrombotic therapy were less often previously diagnosed with atrial fibrillation (59.8%, p<0.0001) and they had the lowest risk for ischemic stroke (CHADS2=2.9±1.2, p<0.0001). Patients with prior anticoagulant therapy had better clinical outcomes with the lowest disability levels at discharge compared to patients in other two groups, but statistically significant difference was shown only in comparison to patients with prior antiplatelet therapy (mRS 3.8±1.9 vs. 4.4±1.6, p<0.0001). There were no statistically significant differences between the groups in terms of stroke severity, size and localization of stroke. Discussion: Our study showed that patients with prior anticoagulant therapy had better clinical outcomes in comparison to patients with prior antiplatelet therapy. Antiplatelet therapy has a already a less pronounced role in cardioembolic stroke prevention, and according to the results of our study, its significance can be further questioned.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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