Recurrence Of Stroke In Patients With AF Using NOACs | 93845
Journal of General Practice
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Objective: To evaluate the risk factors of recurrent???thromboembolic cerebral infarction in patients with non-valvular atrial
fibrillation (NVAF), who were treated with non-vitamin K antagonist oral anticoagulants (NOACs).
Methods: The data of patients collected from the database of our institute for about 3 years (between 2013 April to 2015
Results: We analysed 16 patient???s data (14 male, 2 female, median age 67.0 years) in whom recurrent thromboembolic cerebral
infarction occurred despite receiving NOACs. In 14 of 16 patients with recurrent ischemic stroke, received reduced dose drug
and in 10 of 14 patient with reduced dose drug, inappropriate dose setting (that is out of drug dose criteria of NOACs) has
been selected by the physicians or practitioner concerning about the risk for intracranial hemorrhage and patient???s age. After
we have changed to the appropriate dose, recurrence of thromboembolic cerebral infarction was not observed.
More than 70% of recurrent cerebral infarction occurred in patients with inappropriate under-dose use of NOACs.
Conclusions: This paper demonstrates that patients with inappropriate reduced dose selection of NOACs carries a significant
risk of recurrent thromboembolic cerebral infarction despite treated with NOACs anticoagulation, highlighting the need for
appropriate drug dose selection for stroke prevention in real world NVAF patients.
1. Recurrence of stroke in patients with AF using NOACs TREATMENT OF NON-VITAMIN K ANTAGONIST ORAL
ANTICOAGULANTS FOR PREVENTION OF STROKE
Yasushi Ueno has his expertise in neurosurgery and stroke prevention. Especially he has a lot of clinical data about acute ischemic stroke and vascular recanalization flowing medical preservation using DOACs (direct oral anticoagulants). He has built this clinical data after years of experience in bed side work, research, evaluation, and administration both in Shinko hospital and education institutions; Kyoto University.