Key result
Five-year mortality reaches ~30% following ischemic stroke or TIA in the DOAC era.
Why the study?
Long-term outcomes of patients with ischemic stroke or TIA after widespread use of direct oral anticoagulants were not well characterized.
Cohort (n=555)
No
Despite the widespread use of DOACs, 5-year mortality (30%) and stroke recurrence (19%) remain high among patients with ischemic stroke or TIA, particularly in those with cardioembolism.
High mortality and recurrence persist despite DOACs; leaves open whether intensified prevention improves long-term outcomes in stroke/TIA.
The long-term outcomes of patients with stroke or transient ischemic attack (TIA) after widespread use of direct oral anticoagulants (DOACs) were investigated. Patients with ischemic stroke or TIA admitted between April 2014 and September 2015 were prospectively enrolled and followed for up to 5 years after the index stroke or TIA. Primary outcome measures were any cause of death and stroke recurrence. A total of 555 consecutive patients (323 men; mean age, 75 years; ischemic stroke, n = 520; TIA, n = 35) were analyzed. The follow-up rate was 93%, and the mean follow-up period was 48 ± 20 months. DOACs accounted for 52% of anticoagulants at discharge. During follow-up, 162 patients died, for cumulative mortality rates of 30% (particularly, 53% in cardioembolism) at 5 years. Recurrent stroke occurred in 90 patients, with cumulative risks of stroke recurrence of 19% at 5 years. The 5-year mortality rate remain even after widespread use of DOACs, and further treatment approaches are warranted.
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Nagakane et al. (2024) conducted a cohort in Ischemic stroke or transient ischemic attack (TIA) (n=555). Ischemic stroke or TIA in the DOAC era was evaluated on Any cause of death and stroke recurrence at 5 years. In a prospective cohort of patients with ischemic stroke or TIA during the DOAC era, the 5-year cumulative mortality rate was 30.2% and the stroke recurrence rate was 18.7%.
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