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.
|Number of pages||4|
|Journal||Journal of Stroke and Cerebrovascular Diseases|
|Publication status||Published - 2018 May|
- risk factor
ASJC Scopus subject areas
- Clinical Neurology
- Cardiology and Cardiovascular Medicine