Helsinki experience on nonvitamin K oral anticoagulants for treating cervical artery dissection

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http://hdl.handle.net/10138/166369

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Mustanoja , S , Metso , T M , Putaala , J , Heikkinen , N , Haapaniemi , E , Salonen , O & Tatlisumak , T 2015 , ' Helsinki experience on nonvitamin K oral anticoagulants for treating cervical artery dissection ' , Brain and Behavior , vol. 5 , no. 8 , 00349 . https://doi.org/10.1002/brb3.349

Title: Helsinki experience on nonvitamin K oral anticoagulants for treating cervical artery dissection
Author: Mustanoja, Satu; Metso, Tiina M.; Putaala, Jukka; Heikkinen, Noora; Haapaniemi, Elena; Salonen, Oili; Tatlisumak, Turgut
Contributor organization: Department of Neurosciences
Neurologian yksikkö
Clinicum
Department of Diagnostics and Therapeutics
Date: 2015-08
Language: eng
Number of pages: 4
Belongs to series: Brain and Behavior
ISSN: 2162-3279
DOI: https://doi.org/10.1002/brb3.349
URI: http://hdl.handle.net/10138/166369
Abstract: BackgroundCervical artery dissection (CeAD) patients with or without stroke are frequently treated with either antiplatelet agents or vitamin K antagonists (VKAs), but few data are reported on the use of nonvitamin K oral anticoagulants (NOACs). MethodsBetween November 2011 and January 2014, we recorded data from patients with a stroke due to vertebral (VAD) or internal carotid artery dissection (ICAD). Patients using oral anticoagulants were included in the study and were divided into two treatment groups: patients using NOACs and those using VKAs. Excellent outcome was defined on modified Rankin Scale (mRS) 1 at 6months. ResultsOf 68 stroke patients (67% male; median age 45 [39-53]), six (8.8%; two with VAD and four with ICAD) were treated with NOACs: three with direct thrombin inhibitor dabigatran and three with direct factor Xa inhibitor rivaroxaban. National Institutes of Health Stroke Scale score at baseline was 4 (3-7) in the NOAC versus 2 (1-7) in the VKA groups. Complete recanalization at 6months was seen in most patients in the NOAC (n=5; 83%) and VKA (n=34; 55%) groups. All the patients using NOACs had mRS 1 at 6months and none had an intracerebral hemorrhage (ICH). In the VKA group most patients (n=48; 77%) had mRS 1, one patient (1.7%) had an ICH and one died. ConclusionsIn this small, consecutive single-center patient sample treating ischemic stroke patients with CeAD with NOACs did not bring up safety concerns and resulted in similar, good outcomes compared to patients using VKAs.
Subject: Acute stroke
anticoagulation
cervical arterial dissection
NONVALVULAR ATRIAL-FIBRILLATION
WARFARIN
RISK
3124 Neurology and psychiatry
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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