Key result
Warfarin dose variation and BMI fail to predict recurrent stroke in AF patients on anticoagulation.
Why the study?
Recurrent stroke in patients with AF remains a clinical problem despite warfarin therapy, prompting an evaluation of clinical factors associated with stroke recurrence in this population.
Cohort (n=50)
Yes
In this small retrospective cohort of patients with atrial fibrillation and prior ischemic stroke on warfarin, 22% experienced stroke recurrence, though no clinical factors emerged as statistically significant independent predictors.
Recurrent stroke remains frequent in AF on warfarin without identifiable clinical predictors; leaves open whether other factors drive risk in this population.
Recurrent stroke in patients with atrial fibrillation (AF) remains a clinical problem despite warfarin therapy. This study aimed to identify clinical factors associated with recurrent stroke in AF patients receiving warfarin. A retrospective cohort study was conducted among 50 patients with ischemic stroke and AF who received warfarin for at least one year at Dr. Sardjito General Hospital, Yogyakarta, and Dr. Moewardi General Hospital, Surakarta, during 2015–2019. Bivariate and multivariate logistic regression analyses were performed to assess the association between clinical factors and recurrent stroke. Eleven patients (22%) experienced recurrent stroke. Bivariate analysis showed that warfarin dose switching, dose variation, and body mass index were associated with recurrent stroke. However, conventional multivariate logistic regression and Firth’s penalized logistic regression did not confirm these variables as significant independent predictors. The wide confidence intervals, which included 1, reflected the limited sample size and number of events. Mean INR (p=0.06) and INR monitoring frequency (p=0.27) were also not significantly associated with recurrent stroke. This study concludes that no clinical factor was identified as a significant independent predictor of recurrent stroke. The findings are exploratory and support comprehensive therapeutic management, including maintaining warfarin dose stability and considering patient characteristics such as body mass index
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Fauzi et al. (2026) conducted a cohort in Ischemic stroke and atrial fibrillation (n=50). Clinical factors (warfarin dose switching, dose variation, body mass index, mean INR, INR monitoring frequency) was evaluated on Recurrent stroke. Clinical factors including warfarin dose variation and BMI were not independent predictors of recurrent stroke (22% event rate) in AF patients on warfarin.
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