JNNP-Atrial fibrillation causes ischemic stroke, and the risk of stroke recurrence after anticoagulation is higher

Atrial fibrillation (AF) is associated with an increased risk of ischemic stroke .
Studies have shown that oral anticoagulation therapy is associated with a decrease in the risk of ischemic stroke
.

However, despite anticoagulant therapy, the risk of ischemic stroke in AF patients is still elevated

Stroke

Importantly, in patients with previous strokes or TIAs, this risk is almost doubled (nearly 4/100 patient-years)
.

A recent study compared direct oral anticoagulants (DOACs) with warfarin and aspirin and found a similar trend.

Blood vessel

It is worth noting that switching to a different type of anticoagulant did not reduce the risk of stroke recurrence, indicating that pharmacokinetic and dosage considerations are not sufficient to explain the continued increased risk
.

However, these studies have not adjusted for important biomarkers of atrial disease, and the presence/absence of competing large atherosclerotic mechanisms that indicate a high risk of recurrence

With this, Shadi yaghi and others of Brown University tried to assess the short-term risk of stroke recurrence, and expanded these findings in a large multicenter study by considering cardiac biomarkers and the mechanism of competitive aortic atherosclerosis stroke
.

Expanding these findings in a large multicenter study by considering cardiac biomarkers and the mechanisms of competitive large atherosclerotic stroke
.

Expanding these findings in a large multicenter study by considering cardiac biomarkers and the mechanisms of competitive large atherosclerotic stroke

Prevention and management of patients with atrial fibrillation who received anticoagulation therapy had a higher risk of recurrence in the short term compared with patients who did not receive anticoagulation therapy

In the adjusted Cox risk model, ACp is only in the fully adjusted model with some evidence that the risk of recurring ischemic events at 90 days is higher (adjusted HR is 1.

50, 95% CI is 0.
99 to 2.

In addition , the conversion of anticoagulation levels is associated with a reduction in the risk of recurrent ischemic events (adjusted HR of 0.
41, 95% CI of 0.
12 to 1.
33, p=0.
136) or sICH (adjusted HR of 1.
47, 95% CI of 0.
29) To 7.
50, p=0.
641) It does not matter
.

, Conversion of anticoagulation grade and reduction in risk of recurrent ischemic events (adjusted HR of 0.
41, 95% CI of 0.
12 to 1.
33, p=0.
136) or sICH (adjusted HR of 1.
47, 95% CI of 0.
29 to 7.
50, p=0.
641) It does not matter
.

, Conversion of anticoagulation grade and reduction in risk of recurrent ischemic events (adjusted HR of 0.

Original source:
Yaghi S, Henninger N, Giles JA, et al
Ischaemic stroke on anticoagulation therapy and early recurrence in acute cardioembolic stroke: the IAC study
Journal of Neurology, Neurosurgery & Psychiatry Published Online First: 26 April 2021.

doi: 10.
1136/jnnp -2021-326166

 

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