PMID- 31982816
OWN - NLM
STAT- MEDLINE
DCOM- 20210514
LR  - 20210514
IS  - 1878-5883 (Electronic)
IS  - 0022-510X (Linking)
VI  - 410
DP  - 2020 Mar 15
TI  - Influence of oral anticoagulation on stroke severity and outcomes: A propensity 
      score matching case-control study.
PG  - 116685
LID - S0022-510X(20)30021-6 [pii]
LID - 10.1016/j.jns.2020.116685 [doi]
AB  - BACKGROUND: Oral anticoagulants (OAC) such as vitamin K antagonists (VKA) and 
      direct-acting OACs (DOAC) remain the mainstay for prevention of cardioembolic 
      stroke. The influence of previous OAC treatment on stroke severity and outcomes 
      is not well stablished. We compared patients with incident cardioembolic strokes 
      according to pre-stroke treatment. METHODS: Retrospective observational study of 
      patients with cardioembolic stroke. Demographic data, vascular risk factors, 
      pre-stroke treatments, reperfusion therapies and outcomes were analyzed. 
      Propensity score matching of baseline characteristics was used to compare 
      case-control samples across different treatment groups: adequate OAC vs no OAC; 
      inadequate VKA vs no OAC; adequate VKA vs inadequate VKA; adequate VKA vs DOAC. 
      RESULTS: 462 patients (76 +/- 11.6 years) included. 255 (55%) had a known major 
      cardioembolic source, but only 151 (59%) of them were under OAC upon admission 
      (127 VKA, 24 DOAC). Four patients received VKA for other reasons. Of those taking 
      VKA, 91 (69%) had an inadequate anticoagulation. After propensity score matching, 
      we found no significant differences in stroke severity across the different 
      groups. Patients receiving DOAC had lower mortality at 3 months (8% vs 33%, 
      p = .033) and higher successful recanalization rates after thrombectomy (100% vs 
      25%, p = .033) compared with adequate VKA anticoagulation. CONCLUSIONS: DOAC 
      treatment significantly reduced mortality at three months compared with adequate 
      VKA anticoagulation. Further studies are needed to confirm its influence on 
      endovascular thrombectomy outcomes.
CI  - Copyright (c) 2020 Elsevier B.V. All rights reserved.
FAU - Rodriguez-Pardo, J
AU  - Rodriguez-Pardo J
AD  - La Paz University Hospital, Department of Neurology, Autonomous University of 
      Madrid, Spain. Electronic address: jrpardodedonlebun@salud.madrid.org.
FAU - Plaza Herraiz, A
AU  - Plaza Herraiz A
AD  - Neurology Department, La Paz University Hospital, Spain.
FAU - Lobato-Perez, L
AU  - Lobato-Perez L
AD  - Neurology Department, La Paz University Hospital, Spain.
FAU - Ramirez-Torres, M
AU  - Ramirez-Torres M
AD  - Neurology Department, La Paz University Hospital, Spain.
FAU - De Lorenzo, I
AU  - De Lorenzo I
AD  - Neurology Department, La Paz University Hospital, Spain.
FAU - Alonso de Lecinana, M
AU  - Alonso de Lecinana M
AD  - Neurology Department, La Paz University Hospital, Spain. Electronic address: 
      malecinanacases@salud.madrid.org.
FAU - Diez-Tejedor, E
AU  - Diez-Tejedor E
AD  - La Paz University Hospital, Department of Neurology, Autonomous University of 
      Madrid, Spain. Electronic address: exuperio.diez@salud.madrid.org.
FAU - Fuentes, B
AU  - Fuentes B
AD  - La Paz University Hospital, Department of Neurology, Autonomous University of 
      Madrid, Spain. Electronic address: blanca.fuentes@salud.madrid.org.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20200114
PL  - Netherlands
TA  - J Neurol Sci
JT  - Journal of the neurological sciences
JID - 0375403
RN  - 0 (Anticoagulants)
SB  - IM
MH  - Administration, Oral
MH  - Anticoagulants/therapeutic use
MH  - *Atrial Fibrillation/drug therapy
MH  - Case-Control Studies
MH  - Humans
MH  - Propensity Score
MH  - *Stroke/complications/drug therapy
OTO - NOTNLM
OT  - Anticoagulants
OT  - Prognosis
OT  - Stroke
OT  - Stroke severity
EDAT- 2020/01/27 06:00
MHDA- 2021/05/15 06:00
CRDT- 2020/01/27 06:00
PHST- 2019/07/23 00:00 [received]
PHST- 2020/01/06 00:00 [revised]
PHST- 2020/01/13 00:00 [accepted]
PHST- 2020/01/27 06:00 [pubmed]
PHST- 2021/05/15 06:00 [medline]
PHST- 2020/01/27 06:00 [entrez]
AID - S0022-510X(20)30021-6 [pii]
AID - 10.1016/j.jns.2020.116685 [doi]
PST - ppublish
SO  - J Neurol Sci. 2020 Mar 15;410:116685. doi: 10.1016/j.jns.2020.116685. Epub 2020 
      Jan 14.