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   impact of pre-admission treatment with non-vitamin k oral anticoagulants on stroke severity in patients with acute ischemic stroke  
   
نویسنده hoyer carolin ,filipov alexandra ,neumaier-probst eva ,szabo kristina ,ebert anne ,alonso angelika
منبع journal of thrombosis and thrombolysis - 2018 - دوره : 45 - شماره : 4 - صفحه:529 -535
چکیده    Non-vitamin k antagonist oral anticoagulants (noacs) have gained increasing importance for stroke prevention in patients with non-valvular atrial fibrillation (af). with changing prescription practice, among other factors, clinicians can expect to see rising numbers of patients with ischemic stroke and pre-existing noac therapy. few data exist regarding a potential impact of noac on stroke severity and outcome. to evaluate the impact of pre-admission noac therapy on ischemic stroke severity. retrospective analysis of medical data of 376 patients with newly detected af or known af with either no pre-admission oral anticoagulation (n = 277) or existing noac therapy (n = 99; apixaban, n = 33, dabigatran, n = 16; edoxaban, n = 1; rivaroxaban, n = 49) consecutively admitted for acute ischemic stroke between 2015 and 2016. patients with pre-admission noac had significantly more often experienced a prior stroke than patients not on noac therapy (45.5 vs. 18.4%, p < 0.001) and were significantly more frequently non-smokers (1.0 vs. 7.2%, p = 0.021). significantly more patients without pre-admission noac received thrombolysis (33.8 vs. 8.1%, p < 0.001). pre-admission noac therapy was associated with significantly lower nihss and mrs scores upon admission (median nihss score 6 vs. 10, p = 0.018, median mrs score 4 vs. 5, p = 0.035) and trend-level lower nihss scores at discharge (median nihss score 3 vs. 5, p = 0.057). there were no differences regarding the frequency of symptomatic intracerebral hemorrhage between noac and non-noac patients (p > 0.05). we report a positive impact of pre-admission noac on ischemic stroke severity, which is particularly remarkable in light of the increased prevalence of prior stroke and lower rates of thrombolysis in this patient population.
کلیدواژه atrial fibrillation ,noac ,secondary prevention ,neurology ,ischemic stroke ,stroke severity
آدرس universitätsmedizin mannheim, university of heidelberg, department of neurology, germany, universitätsmedizin mannheim, university of heidelberg, department of neurology, germany, universitätsmedizin mannheim, university of heidelberg, department of neuroradiology, germany, universitätsmedizin mannheim, university of heidelberg, department of neurology, germany, universitätsmedizin mannheim, university of heidelberg, department of neurology, germany, universitätsmedizin mannheim, university of heidelberg, department of neurology, germany
 
     
   
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