Advertisement

Ninety-day prognosis of patients receiving direct oral anticoagulants in the early phase of non valvular atrial fibrillation-related acute ischemic stroke: The real life evidence

Published:November 03, 2018DOI:https://doi.org/10.1016/j.thromres.2018.11.004

      Highlights

      • The optimal starting time of anticoagulation in the early phase of NVAF-related AIS is unclear
      • Balancing the risk of early stroke recurrence and hemorrhagic transformation is the key-point of NVAF-related AIS management
      • Patients with acute stroke were excluded from randomized clinical trials of DOACs on stroke prevention in atrial fibrillation
      • Real life studies showed an optimal efficacy/safety profile of DOACs in the early phase of NVAF-related AIS
      • Results of randomized clinical trials on DOACs aimed to confirm the real life evidence in this clinical setting are awaited

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Thrombosis Research
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Abdul-Rahim A.H.
        • Fulton R.L.
        • Frank B.
        • Tatlisumak T.
        • Paciaroni M.
        • Caso V.
        • Diener H.C.
        • Lees K.R.
        • VISTA collaborators
        Association of improved outcome in acute ischaemic stroke patients with atrial fibrillation who receive early antithrombotic therapy: analysis from VISTA.
        Eur. J. Neurol. 2015; 22: 1048-1055
        • Paciaroni M.
        • Agnelli G.
        • Falocci N.
        • et al.
        Early recurrence and cerebral bleeding in patients with acute ischemic stroke and atrial fibrillation: effect of anticoagulation and its timing: the RAF study.
        Stroke. 2015; 46: 2175-2182
        • Ntaios G.
        • Papavasileiou V.
        • Diener H.C.
        • Makaritsis K.
        • Michel P.
        Nonvitamin-K-antagonist oral anticoagulants versus warfarin in patients with atrial fibrillation and previous stroke or transient ischemic attack: an updated systematic review and meta-analysis of randomized controlled trials.
        Int. J. Stroke. 2017; 12: 589-596
        • Ruff C.T.
        • Giugliano R.P.
        • Braunwald E.
        • Hoffman E.B.
        • et al.
        Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials.
        Lancet. 2014; 383: 955-962
        • Steffel J.
        • Verhamme P.
        • Potpara T.S.
        • ESC Scientific Document Group
        • et al.
        The 2018 European heart rhythm association practical guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation.
        Eur. Heart J. 2018; 39: 1330-1393
        • Hong K.S.
        • Kwon S.U.
        • Lee S.H.
        • et al.
        Phase 2 exploratory clinical study to assess the effects of Xarelto (rivaroxaban) versus warfarin on ischemia, bleeding, and hospital stay in acute cerebral infarction patients with non-valvular atrial fibrillation (Triple AXEL) study group. Rivaroxaban vs warfarin sodium in the ultra-early period after atrial fibrillation-related mild ischemic stroke: a randomized clinical trial.
        JAMA Neurol. 2017; 74: 1206-1215
        • Moroni F.
        • Masotti L.
        • Vannucchi V.
        • et al.
        Confidence in use of direct oral anticoagulants in the acute phase of non valvular atrial fibrillation-related ischemic stroke over the years: a real world single centre study.
        J. Stroke Cerebrovasc. Dis. 2018; 27: 76-82
        • Paciaroni M.
        • Agnelli G.
        • Falocci N.
        • et al.
        Early recurrence and major bleeding in patients with acute ischemic stroke and atrial fibrillation treated with non-vitamin-K oral anticoagulants (RAF-NOACs) study.
        J. Am. Heart Assoc. 2017; 6
        • Arihiro S.
        • Todo K.
        • Koga M.
        • et al.
        SAMURAI study investigators. Three-month risk-benefit profile of anticoagulation after stroke with atrial fibrillation: the SAMURAI-nonvalvular atrial fibrillation (NVAF) study.
        Int. J. Stroke. 2016; 11: 565-574
        • Gioia L.C.
        • Kate M.
        • Sivakumar L.
        • Hussain D.
        • et al.
        Early rivaroxaban use after Cardioembolic stroke may not result in hemorrhagic transformation: a prospective magnetic resonance imaging study.
        Stroke. 2016; 47: 1917-1919
        • Seiffge D.J.
        • Traenka C.
        • Polymeris A.
        • et al.
        Early start of DOAC after ischemic stroke: risk of intracranial hemorrhage and recurrent events.
        Neurology. 2016; 87: 1856-1862
        • Cappellari M.
        • Carletti M.
        • Danese A.
        • Bovi P.
        Early introduction of direct oral anticoagulants in cardioembolic stroke patients with non-valvular atrial fibrillation.
        J. Thromb. Thrombolysis. 2016; 42: 393-398
        • Monteagudo M.
        • Fernandez-Diaz E.
        • Garcia-Garcia J.
        • Ayo-Martin O.
        • Hernandez-Fernandez F.
        • Segura T.
        Efficacy, safety and tolerability of rivaroxaban for the secondary prevention of stroke in patients with atrial fibrillation in clinical practice.
        Future Neurol. 2015; 10: 529-536
        • Shibazaki K.
        • Kimura K.
        • Aoki J.
        • Saji N.
        • Sakai K.
        Early initiation of new oral anticoagulants in acute stroke and TIA patients with nonvalvular atrial fibrillation.
        J. Neurol. Sci. 2013; 331: 90-93
        • Powers W.J.
        • Rabinstein A.A.
        • Ackerson T.
        • et al.
        2018 guidelines for the early management of patients with acute ischemic stroke. A guideline for healthcare professionals from the American Heart Association/American Stroke Association.
        Stroke. 2018; 49: e46-e110
        • Steffel J.
        • Verhamme P.
        • Potpara T.S.
        • ESC Scientific Document Group
        • et al.
        The 2018 European heart rhythm association practical guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation.
        Eur. Heart J. 2018; 39: 1330-1393