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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Selection of Oral Anticoagulants in Ischemic Stroke Patients with Nonvalvular Atrial Fibrillation
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Selection of Oral Anticoagulants in Ischemic Stroke Patients with Nonvalvular Atrial Fibrillation

机译：非血管性心房颤动缺血性脑卒中患者口腔抗凝血剂的选择

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BackgroundAnticoagulant therapy is indicated for management of ischemic stroke patients with nonvalvular atrial fibrillation. We retrospectively investigated how oral anticoagulants were selected for ischemic stroke patients with nonvalvular atrial fibrillation. MethodsThis study included 297 stroke patients with nonvalvular atrial fibrillation admitted to our hospital between September 2014 and December 2017, and who were subsequently transferred to other institutions or discharged home. Baseline clinical characteristics were compared between patients prescribed warfarin and those prescribed direct-acting oral anticoagulants. ResultsIn total, 280 of 297 (94.3%) patients received oral anticoagulant therapy, including 36 with warfarin, while 244 received direct oral anticoagulants. Age, percentage of heart failure, CHADS2score before stroke onset, percentage of treatment with warfarin on admission, percentage of feeding tube at hospital discharge, and modified Rankin Scale at hospital discharge were significantly higher in the warfarin group versus the direct oral anticoagulants group, while creatinine clearance was significantly higher in the direct oral anticoagulant group. By multiple logistic regression, taking warfarin at admission and higher modified Rankin Scale at hospital discharge were associated with warfarin selection, while higher creatinine clearance was associated with direct oral anticoagulant selection (warfarin: odds ratio [OR] 7.10 [95% confidence interval {CI} 2.83-17.81]; modified Rankin Scale at hospital discharge: [OR] 1.47 [95% {CI} 1.06-2.04]; creatinine clearance: [OR] .97 [95% {CI} .95-.99]). ConclusionsSelection of oral anticoagulants in acute ischemic stroke patients with nonvalvular atrial fibrillation was influenced by warfarin use at admission, clinical severity at hospital discharge, and renal function.
机译：表明缺血性卒中患者的缺血性脑颤患者的管理表明了背景。我们回顾性地调查了如何为缺血性脑卒中患者选择口腔抗凝血剂的缺血性脑颤患者。方法研究包括2014年9月至2017年12月至12月在2017年12月至2017年12月期间录取了297名脑卒中患者，随后被转移到其他机构或被排放为家庭。在规定华法林的患者和规定的直接作用口服抗凝剂的患者之间进行基线临床特征。结果总计280例297（94.3％）患者接受口服抗凝血治疗，其中36例与华法林，而244则接受直接口服抗凝剂。年龄，心力衰竭的百分比，中风前发病前，华法林治疗的百分比，医院排放中的饲养管百分比，以及医院放电的改良Rankin规模在Warfarin组与直接口服抗凝血剂组显着高，同时直接口服抗凝剂组肌酐清除显着高。通过多种逻辑回归，在入学袭击和高等修改的Rankin规模在医院出院与Warfarin选择相关，而较高的肌酐间隙与直接口服抗凝剂选择有关（华法林：差距[或] 7.10 [95％置信区间{CI 2.83-17.81];在医院放电修改Rankin规模：[或] 1.47 [95％{Ci} 1.06-2.04];肌酐清除：[或] .97 [95％{Ci} .95-.99]）。结论急性心房颤动急性缺血患者口服抗凝血剂的选择受到华法林在入院，医院排放治疗临床严重程度和肾功能的影响。

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