• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Acute Ischemic Stroke Outcome and Preceding Anticoagulation: Direct Oral Anticoagulants Versus Vitamin K Antagonists
【24h】

Acute Ischemic Stroke Outcome and Preceding Anticoagulation: Direct Oral Anticoagulants Versus Vitamin K Antagonists

机译：急性缺血性卒中结果和前抗凝：直接口服抗凝血剂与维生素K拮抗剂

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Background and Purpose: Acute ischemic stroke (AIS) severity and clinical course are less known in direct oral anticoagulants (DOAC) users. We aimed to explore the outcome of AIS in patients pretreated with vitamin-K-antagonists (VKA) and DOAC. Methods: A retrospective study was performed. Patients pretreated with oral anticoagulants (OAC) for nonvalvular atrial fibrillation admitted for AIS in a stroke unit between 2016-01-01 and 2018-08-31 were included. The primary endpoint was mortality during the hospital stay, and secondary endpoints were neurologic improvement at stroke unit discharge and good functional outcome 90 days after AIS. Results: A total of 156 patients were included (83 on VKA and 73 on DOAC). Stroke severity (defined by NIHSS on admission) was comparable in both groups (AVK 13.0 [4.0-20.0] versus DOAC 11.0 [4.0-17.0], P = .435). Infratherapeutic levels and/or inappropriate low dose of OAC was also similar between groups (P = .152) and was not associated with stroke severity (P = .631) or mortality (P = .788). VKA (OR 12.616, P = .035, 95%CI 1.19-133.64) and PH2 hemorrhagic transformation (OR 7.516, P = .024, 95%CI 1.31-43.20) were associated with higher mortality in multivariate analysis. Higher stroke severity (OR .101, P < .001, 95%CI .037-.279) and VKA usage (OR .212, P = .003, 95%CI .08-.58) were associated with worse functional outcome at 3 months. Reperfusion therapy was significantly associated with neurologic improvement during stroke unit stay (OR 3.969, P = .009, 95%CI 1.42-11.11) but not with the functional outcome (P = .063). Conclusions: Nonvalvular atrial fibrillation patients pretreated with DOAC admitted for AIS had a better outcome when compared to VKA, although stroke severity was similar between groups.
机译：背景和目的：直接口服抗凝剂（DOAC）使用者对急性缺血性卒中（AIS）的严重程度和临床病程知之甚少。我们旨在探讨维生素K拮抗剂（VKA）和DOAC预处理患者的AIS结果。方法：回顾性研究。包括2016年1月1日至2018年8月31日在卒中单元接受口服抗凝剂（OAC）治疗的非瓣膜性心房颤动患者。主要终点是住院期间的死亡率，次要终点是卒中单元出院时的神经功能改善和AIS后90天的良好功能结果。结果：共纳入156例患者（VKA 83例，DOAC 73例）。两组的卒中严重程度（入院时由NIHSS定义）具有可比性（AVK 13.0[4.0-20.0]与DOAC 11.0[4.0-17.0]，P=0.435）。两组间的基础治疗水平和/或不适当的低剂量OAC也相似（P=0.152），与卒中严重程度（P=0.631）或死亡率（P=0.788）无关。在多变量分析中，VKA（OR 12.616，P=0.035，95%可信区间1.19-133.64）和PH2出血性转化（OR 7.516，P=0.024，95%可信区间1.31-43.20）与较高的死亡率相关。卒中严重程度较高（OR.101，P<0.001，95%可信区间为0.037-0.279）和VKA使用率较高（OR.212，P=0.003，95%可信区间为0.08-0.58）与3个月时的功能预后较差相关。再灌注治疗与卒中单元住院期间的神经功能改善显著相关（OR 3.969，P=0.009，95%可信区间1.42-11.11），但与功能结果无关（P=0.063）。结论：与VKA相比，接受DOAC预处理的AIS非瓣膜性心房颤动患者的预后更好，尽管两组之间的卒中严重程度相似。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号