Key result
Suboptimal OAC treatment is linked to ~30% of breakthrough ischemic strokes in AFib.
Why the study?
Oral anticoagulation prevents stroke in atrial fibrillation, yet a residual stroke risk remains.
What are the underlying causes of acute ischemic stroke in patients with atrial fibrillation who are prescribed oral anticoagulants?
Observational (n=173)
No
What are the underlying causes of acute ischemic stroke in patients with atrial fibrillation who are prescribed oral anticoagulants?
A significant proportion of ischemic strokes in atrial fibrillation patients on oral anticoagulants are due to easily modifiable factors such as suboptimal dosing, non-adherence, and treatment interruption.
Answers are grounded in this paper and cite their sources.
Suboptimal OAC management may contribute to AF-related strokes; leaves open whether optimization reduces events in prospective studies.
Oral anticoagulation (OAC) prevents stroke in atrial fibrillation, yet a residual stroke risk remains. In this single-center retrospective analysis of acute ischemic stroke patients despite OAC, suboptimal OAC treatment is common (30%: inappropriate dosing (17%); patient non-adherence (13%)). Other causes of stroke included OAC interruption (14.5%), a competing stroke mechanism (11.0%), and undetermined breakthrough stroke in 44.5%. Overall, easily modifiable causes of ischemic stroke despite OAC are common. Accordingly, strategies to improve treatment compliance, including appropriate dosing along with guideline-based risk factor and periprocedural OAC management, should be emphasized to improve secondary stroke prevention in this patient population.
No takes yet. Share an insight, caveat, or question.
Dubé et al. (2024) conducted an observational in Ischemic stroke despite oral anticoagulant use for atrial fibrillation (n=173). Oral anticoagulants (OAC) was evaluated on Suboptimal OAC treatment as identified stroke mechanism. Among 173 patients with acute ischemic stroke despite oral anticoagulation for atrial fibrillation, suboptimal treatment was identified as the cause in 30% of cases.
Synapse has enriched 10 related papers. Consider them for comparative context: