Sauer R, Sauer EM, Bobinger T, Blinzler C, Huttner H, Schwab S, Köhrmann M (2015)
Publication Type: Journal article
Publication year: 2015
Book Volume: 24
Pages Range: 78-82
Journal Issue: 1
DOI: 10.1016/j.jstrokecerebrovasdis.2014.07.032
Patients with ischemic stroke caused by atrial fibrillation (AF) have a high risk of recurrence without adequate secondary prevention with oral anticoagulation (OAC). We investigated adherence to OAC in the first year after introduction of direct oral anticoagulants.In 284 appropriate patients, the rate of anticoagulation (AC) at discharge, adherence at 90 days and 1 year, changes between substances, and predictors for adherence to AC were analyzed. Functional outcome was assessed using the modified Rankin Scale score.AC was initiated in 70.3% of survivors before discharge. In these patients, only 8.6% and 9.9% discontinued AC after 90 days and 1 year, respectively. In 22.1%, AC was recommended but not started before discharge. Only 53.2% of them received AC at 90 days, increasing to 67.5% at 1 year. A total of 7.6% of patients were deemed unsuitable for AC, none of them subsequently received AC. Overall, 85.4% of patients suitable for AC were treated at 1-year follow-up. No independent predictors for withholding AC were identified. Switching of medication occurred in only a minority of patients within the first year.AC is feasible in more than 90% patients with acute ischemic stroke and AF. When initiated during the acute hospital stay, AC is discontinued in only a minority of patients. However, if AC is recommended but not started during initial hospitalization the rate of AC treatment at 90 days and 1 year is much lower. Therefore, AC should be initiated within the acute hospital stay whenever possible.
APA:
Sauer, R., Sauer, E.-M., Bobinger, T., Blinzler, C., Huttner, H., Schwab, S., & Köhrmann, M. (2015). Adherence to oral anticoagulation in secondary stroke prevention - the first year of direct oral anticoagulants. Journal of Stroke and Cerebrovascular Diseases, 24(1), 78-82. https://doi.org/10.1016/j.jstrokecerebrovasdis.2014.07.032
MLA:
Sauer, Rolf, et al. "Adherence to oral anticoagulation in secondary stroke prevention - the first year of direct oral anticoagulants." Journal of Stroke and Cerebrovascular Diseases 24.1 (2015): 78-82.
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