Why the study?
The role of protein S deficiency in recurrent arterial ischemic stroke remains uncertain, and DOACs like rivaroxaban are not well studied for this condition despite limitations of VKAs.
Does rivaroxaban prevent recurrent ischemic stroke in patients with protein S deficiency?
Does rivaroxaban prevent recurrent ischemic stroke in patients with protein S deficiency?
Rivaroxaban may be a safe and effective alternative to vitamin K antagonists for preventing recurrent ischemic stroke in patients with protein S deficiency.
Protein S deficiency may underlie recurrent arterial stroke in select cases; hypothesis-generating and should not yet change practice or guidelines.
Protein S deficiency is a thrombophilia associated with an increased risk of thromboembolism. Previous studies have shown its role as a predisposing factor for venous thromboembolism, but its role in recurrent arterial ischemic stroke remains uncertain. Here we report a patient with recurrent ischemic stroke due to protein S deficiency. Oral anticoagulant treatment with vitamin K antagonist (VKA) drugs is used to treat and prevent thromboembolic events caused by thrombophilia, but it has many limitations, especially in the case of recurrent thromboembolic events. Direct oral anticoagulants (DOACs) have many advantages over VKA. Previous studies have shown that they are safe in cases of thrombophilia, but they are not well studied in recurrent ischemic stroke due to protein S deficiency. In this study our patient was treated with rivaroxaban. Protein S deficiency may be a predisposing factor in recurrent ischemic stroke, and rivaroxaban can be a safe and effective treatment option. Further studies are needed to confirm our findings.
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Naghavi et al. (2021) studied this question.
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