[Five-year outcomes in patients with ischemic stroke or transient ischemic attack after widespread use of direct oral anticoagulants].

Q4 Medicine

Clinical Neurology Pub Date : 2024-11-22 Epub Date: 2024-10-12 DOI:10.5692/clinicalneurol.cn-001988

Yoshinari Nagakane, Eijirou Tanaka, Takehiro Yamada, Masashi Hamanaka, Jun Fujinami, Shinji Ashida, Yuta Kojima, Keiko Maezono-Kandori, Shiori Ogura, Yasumasa Yamamoto

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引用次数: 0

Abstract

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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[广泛使用直接口服抗凝剂后缺血性中风或短暂性脑缺血发作患者的五年预后]。

研究人员调查了中风或短暂性脑缺血发作（TIA）患者广泛使用直接口服抗凝药（DOACs）后的长期预后。2014年4月至2015年9月期间入院的缺血性中风或TIA患者均接受了前瞻性研究，并在中风或TIA发生后接受了长达5年的随访。主要结局指标为任何原因导致的死亡和中风复发。共分析了 555 名连续患者（323 名男性；平均年龄 75 岁；缺血性卒中，520 人；TIA，35 人）。随访率为 93%，平均随访时间为 48 ± 20 个月。出院时使用的抗凝药物中 DOAC 占 52%。随访期间，162 名患者死亡，5 年累计死亡率为 30%（尤其是心肌栓塞，死亡率为 53%）。90名患者出现中风复发，5年后中风复发的累积风险为19%。即使在广泛使用 DOACs 后，5 年死亡率依然存在，因此需要采取进一步的治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neurology Medicine-Neurology (clinical)

CiteScore

0.30

自引率

0.00%

发文量

147