当前位置： SCI文献检索 > BMC Neurology期刊下所有文献 > Management of oral anticoagulation after cardioembolic stroke and stroke survival data from a population based stroke registry (LuSSt).

Management of oral anticoagulation after cardioembolic stroke and stroke survival data from a population based stroke registry (LuSSt).

Abstract：

BACKGROUND:Cardioembolic stroke (CES) due to atrial fibrillation (AF) is associated with high stroke mortality. Oral anticoagulation (OAC) reduces stroke mortality, however, the impact of OAC-administration during hospital stay post ischemic stroke on mortality is unclear. We determined whether the timing of OAC initiation among other prognostic factors influenced mortality after CES. METHODS:Within the Ludwigshafen Stroke Study (LuSSt), a prospective population-based stroke register, we analysed all patients with a first ever ischemic stroke or TIA due to AF from 2006 until 2010. We analysed whether treatment or non-treatment with OAC and initiation of OAC-therapy during and after hospitalization influenced stroke mortality within 500 days after stroke/TIA due to AF. RESULTS:In total 479 patients had a first-ever ischemic stroke (n = 394) or TIA (n = 85) due to AF. One-year mortality rate was 28.4%. Overall, 252 patients (52.6%) received OAC. In 181 patients (37.8%), OAC treatment was started in hospital and continued thereafter. Recommendation to start OAC post discharge was given in 110 patients (23.0%) of whom 71 patients received OAC with VKA (14.8%). No OAC-recommendation was given in 158 patients (33.0%). In multivariate Cox regression analysis, higher age (HR 1.04; 95% CI 1.02-1.07), coronary artery disease (HR: 1.6; 95% CI 1.1-2.3), higher mRS-score at discharge (HR 1.24; 95% CI 1.09-1.4), and OAC treatment ((no OAC vs started in hospital (HR: 5.4; 95% CI 2.8-10.5), were independently associated with stroke mortality. OAC-timing did not significantly influence stroke mortality (started post discharge vs. started in hospital (HR 0.3; 95% CI 0.07-1.4)). CONCLUSIONS:OAC non-treatment is the main predictor for stroke mortality. Although OAC initiation during hospital stay showed a trend towards higher mortality, early initiation in selected patients is an option as recommendation to start OAC post hospital was implemented in only 64.5%. This rate might be elevated by implementation of special intervention programs.

journal_name

BMC Neurol

journal_title

BMC neurology

authors

Palm F,Kraus M,Safer A,Wolf J,Becher H,Grau AJ

doi

10.1186/s12883-014-0199-7

subject

Has Abstract

pub_date

2014-10-08 00:00:00

pages

199

issn

1471-2377

pii

s12883-014-0199-7

journal_volume

pub_type

杂志文章

在线工具

Management of oral anticoagulation after cardioembolic stroke and stroke survival data from a population based stroke registry (LuSSt).