Key result
Appropriate dosing of DOACs in patients with non-valvular atrial fibrillation and ischemic stroke was associated with a higher frequency of potential embolic sources other than NV AF compared to no anticoagulants (40.6% vs 18.6%, p=0.0002).
Why the study?
Ischemic strokes occurring despite recommended DOAC doses and good adherence had not been sufficiently investigated.
Does the presence of embolic sources other than NVAF contribute to ischemic stroke in NVAF patients taking appropriate doses of DOACs?
Observational (n=523)
No
Does the presence of embolic sources other than NVAF contribute to ischemic stroke in NVAF patients taking appropriate doses of DOACs?
Absolute Event Rate: 40.6% vs 18.6%
p-value: p=0.0002
In NVAF patients who develop ischemic stroke despite taking appropriate doses of DOACs, embolic sources other than NVAF (such as major artery stenosis or aortic arch atheroma) are frequently involved.
Other embolic sources may explain strokes on appropriate DOACs in NVAF; hypothesis-generating and requires prospective confirmation before changing evaluation.
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Nishii et al. (2022) conducted an observational in Acute ischemic stroke with non-valvular atrial fibrillation (n=523). Direct oral anticoagulants (DOACs) vs. No anticoagulants was evaluated on Frequency of potential embolic sources other than NV AF (p=0.0002). Appropriate dosing of DOACs in patients with non-valvular atrial fibrillation and ischemic stroke was associated with a higher frequency of potential embolic sources other than NV AF compared to no anticoagulants (40.6% vs 18.6%, p=0.0002).
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