In post-stroke patients with non-valvular atrial fibrillation, NOACs significantly reduced recurrent infarct volume compared to VKA (3.3 cm3 vs 27.4 cm3, p<0.05).
Cohort (n=84)
No
Does NOAC therapy reduce recurrent stroke volume compared to VKA in post-cardioembolic stroke patients with NVAF?
In patients with NVAF and prior cardioembolic stroke, secondary prevention with NOACs was associated with significantly smaller recurrent stroke volumes compared to VKA therapy.
Absolute Event Rate: 3.3% vs 27.4%
p-value: p=<0.05
Objective: We investigated recurrent stroke volume with nonvalvular atrial fibrillation (NVAF) patients treated with non-vitamin K antagonist oral anticoagulants (NOACs) about clinical backgrounds and number of recurrent stroke. Methods: We administered three NOACs, dabigatran, rivaroxaban and apixaban in 84 post cardioembolic stroke with NVAF. In retrospective study, we measured recurrent stroke volume with MRI volumetry soft and compared them between 7 vitamin K anticoagulant (VKA: warfarin) cases and 10 NOACs cases under anticoagulant therapy. Results: Of 84 cases, 27 cases were started with VKA and switched to NOACs after 7 recurrent stroke. Other 57 cases were directly started with NOACs and 10 cases with NOACs as first anticoagulants had recurrent stroke. The frequency of recurrent stroke during anticoagulant therapy are not different among VKA group and three NOACs group. Recurrent stroke volume is significantly larger in VKA group (27.4 cm3) than in NOACs group (3.3cm3). Conclusions: Secondary prevention with NOACs after stroke might be more beneficial by reducing recurrent infarct volume than VKA.
Oguro et al. (2016) conducted a cohort in Non-valvular atrial fibrillation post cardioembolic stroke (n=84). NOACs (dabigatran, rivaroxaban, apixaban) vs. VKA (warfarin) was evaluated on Recurrent stroke volume (cm3) (p=<0.05). In post-stroke patients with non-valvular atrial fibrillation, NOACs significantly reduced recurrent infarct volume compared to VKA (3.3 cm3 vs 27.4 cm3, p<0.05).