Outcome of Secondary Stroke Prevention in Patients Taking Non–Vitamin K Antagonist Oral Anticoagulants

Taizen Nakase, Junta Moroi, Tatsuya Ishikawa

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Background: Since non–vitamin K antagonist oral anticoagulants (NOACs) were released for clinical use, many studies have investigated its effectiveness in stroke prevention. In this study, to determine whether or not there is a difference in outcome in secondary stroke prevention between warfarin and NOACs, patients with embolic stroke with newly prescribed anticoagulants were prospectively analyzed. Methods: Patients with acute ischemic stroke, who newly started anticoagulant therapy, were consecutively asked to participate in this study. Enrolled patients (76.3 ± 11.0 years old) were classified into warfarin (n = 48), dabigatran (n = 73), rivaroxaban (n = 49), and apixaban (n = 65). The outcome in 1 year was prospectively investigated at outpatient clinic or telephone interview. Recurrence of stroke and death was considered as the critical incidence. Results: The prevalence of risk factors was not different among all medicines. Patients with dabigatran showed significantly younger onset age (P <.001: 72.2 years old) and milder neurologic deficits than patients on other medicines (P <.001). Cumulative incident rates were 7.1%, 15.3%, 19.0%, and 29.7% for dabigatran, apixaban, rivaroxaban, and warfarin, respectively. Dabigatran showed relatively better outcome compared with warfarin (P =.069) and rivaroxaban (P =.055). All patients on NOACs presented lower cumulative stroke recurrence compared with warfarin. Conclusion: Even in the situation of secondary stroke prevention, noninferiority of NOACs to warfarin might be demonstrated.

Original languageEnglish
Pages (from-to)1174-1177
Number of pages4
JournalJournal of Stroke and Cerebrovascular Diseases
Volume27
Issue number5
DOIs
Publication statusPublished - 2018 May
Externally publishedYes

Keywords

  • Kaplan–Meier
  • medication
  • outcome
  • risk factor
  • Stroke

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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