Key result
Preadmission use of warfarin in acute cerebral infarction was associated with a larger 1-week improvement in NIHSS score compared to no warfarin (3.5 vs 0.8; p<0.001).
Why the study?
Does preadmission use of warfarin improve short-term neurological outcomes in patients with acute cerebral infarction?
Observational
Does preadmission use of warfarin improve short-term neurological outcomes in patients with acute cerebral infarction?
Absolute Event Rate: 3.5% vs 0.8%
p-value: p=<0.001
Preadmission use of warfarin in patients with acute cerebral infarction is associated with greater improvement in neurological deficits within the first week.
May enhance early recovery in acute infarction; hypothesis-generating and should not change practice.
BACKGROUND: We hypothesized that patients with cerebral infarction on preadmission warfarin have less severe neurological deficits on admittance, less severe neurological deficits 1 week after the onset of cerebral infarction and a larger improvement as to neurological deficits within 1 week of acute cerebral infarction. METHODS: All patients with cerebral infarction who did not receive thrombolytic treatment were included. Preadmission use of warfarin was registered. The National Institute of Health Stroke Scale (NIHSS) score was obtained on admittance and 7 days after stroke onset. RESULTS: In total, 42 patients (8.1%) used warfarin at the time of stroke onset. The mean NIHSS score on admittance was 6.9 among the patients on warfarin and 5.2 among those without warfarin (p = 0.10). The 1-week improvement in the NIHSS score was 3.5 among the patients on warfarin and 0.8 among the participants without warfarin (p < 0.001). Linear regression showed that a low NIHSS score on day 7 was independently associated with a low NIHSS score on admittance (p < 0.001), low age (p = 0.002) and preadmission use of warfarin (p < 0.001). CONCLUSION: Preadmission warfarin was not associated with less severe neurological deficits on admittance. However, it was related to both less severe neurological deficits 1 week after the onset of cerebral infarction and larger improvement as to neurological deficits within 1 week of acute cerebral infarction.
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Næss et al. (2009) conducted an observational in Acute cerebral infarction. Preadmission use of warfarin vs. No preadmission use of warfarin was evaluated on 1-week improvement in the NIHSS score (p=<0.001). Preadmission use of warfarin in acute cerebral infarction was associated with a larger 1-week improvement in NIHSS score compared to no warfarin (3.5 vs 0.8; p<0.001).
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