Initiation of Guideline-Matched Oral Anticoagulant in Atrial Fibrillation-Related Stroke
- 주제(키워드) Stroke , Atrial fibrillation , Guideline , Anticoagulants , Outcome
- 주제(기타) Clinical Neurology
- 주제(기타) Peripheral Vascular Disease
- 설명문(일반) [Eun, Mi-Yeon] Kyungpook Natl Univ, Chilgok Hosp, Sch Med, Dept Neurol, Daegu, South Korea; [Kim, Jae-Young; Chung, Jong-Won; Bang, Oh Young; Kim, Gyeong-Moon; Seo, Woo-Keun] Sungkyunkwan Univ, Samsung Med Ctr, Sch Med, Dept Neurol, 81 Irwon Ro, Seoul 06351, South Korea; [Kim, Jae-Young; Seo, Woo-Keun] Sungkyunkwan Univ, Samsung Adv Inst Hlth Sci & Technol, Dept Digital Hlth, Seoul, South Korea; [Hwang, Yang-Ha] Kyungpook Natl Univ, Kyungpook Natl Univ Hosp, Sch Med, Dept Neurol, 130 Dongdeok Ro, Daegu 41944, South Korea; [Park, Man-Seok; Kim, Joon-Tae; Choi, Kang-Ho] Chonnam Natl Univ, Chonnam Natl Univ Hosp, Med Sch, Dept Neurol, Gwangju, South Korea; [Jung, Jin-Man] Korea Univ, Coll Med, Ansan Hosp, Dept Neurol, Ansan, South Korea; [Yu, Sungwook] Korea Univ, Coll Med, Anam Hosp, Dept Neurol, Seoul, South Korea; [Kim, Chi Kyung; Oh, Kyungmi] Korea Univ, Coll Med, Guro Hosp, Dept Neurol, Seoul, South Korea; [Song, Tae-Jin] Ewha Womans Univ, Sch Med, Seoul Hosp, Dept Neurol, Seoul, South Korea; [Kim, Yong-Jae] Catholic Univ Kore, Coll Med, Eunpyeong St Marys Hosp, Dept Neurol, Seoul, South Korea; [Kim, Bum Joon] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Neurol, Seoul, South Korea; [Heo, Sung Hyuk] Kyung Hee Univ, Sch Med, Kyung Hee Univ Hosp, Dept Neurol, Seoul, South Korea; [Park, Kwang-Yeol; Kim, Jeong-Min] Chung Ang Univ, Coll Med, Chung Ang Univ Hosp, Dept Neurol, Seoul, South Korea; [Park, Jong-Ho] Hanyang Univ, Coll Med, Myongji Hosp, Dept Neurol, Goyang, South Korea; [Choi, Jay Chol] Jeju Natl Univ, Jeju Natl Univ Hosp, Coll Med, Dept Neurol, Jeju, South Korea
- 등재 SCIE, SCOPUS
- 발행기관 KOREAN STROKE SOC
- 발행년도 2021
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000182273
- 본문언어 영어
- Published As http://dx.doi.org/10.5853/jos.2020.03440
초록/요약
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 (Korean 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 guideline-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 guideline-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.
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