Early Recurrence and Major Bleeding in Patients With Acute Ischemic Stroke and Atrial Fibrillation Treated With Non-Vitamin-K Oral Anticoagulants (RAF-NOACs) Study

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Paciaroni , M , Agnelli , G , Falocci , N , Tsivgoulis , G , Vadikolias , K , Liantinioti , C , Chondrogianni , M , Bovi , P , Carletti , M , Cappellari , M , Zedde , M , Ntaios , G , Karagkiozi , E , Athanasakis , G , Makaritsis , K , Silvestrelli , G , Lanari , A , Ciccone , A , Putaala , J , Tomppo , L , Tatlisumak , T , Abdul-Rahim , A H , Lees , K R , Alberti , A , Venti , M , Acciarresi , M , D'Amore , C , Becattini , C , Mosconi , M G , Cimini , L A , Soloperto , R , Masotti , L , Vannucchi , V , Lorenzini , G , Tassi , R , Guideri , F , Acampa , M , Martini , G , Sohn , S-I , Marcheselli , S , Mumoli , N , De Lodovici , M L , Bono , G , Furie , K L , Tadi , P , Yaghi , S , Toni , D , Letteri , F , Tassinari , T , Kargiotis , O , Lotti , E M , Flomin , Y , Mancuso , M , Maccarrone , M , Giannini , N , Bandini , F , Pezzini , A , Poli , L , Padovani , A , Scoditti , U , Denti , L , Consoli , D , Galati , F , Sacco , S , Carolei , A , Tiseo , C , Gourbali , V , Orlandi , G , Giuntini , M , Chiti , A , Giorli , E , Gialdini , G , Corea , F , Ageno , W , Bellesini , M , Colombo , G , Monaco , S , Baronello , M M , Karapanayiotides , T & Caso , V 2017 , ' Early Recurrence and Major Bleeding in Patients With Acute Ischemic Stroke and Atrial Fibrillation Treated With Non-Vitamin-K Oral Anticoagulants (RAF-NOACs) Study ' , Journal of the American Heart Association , vol. 6 , no. 12 , 007034 . https://doi.org/10.1161/JAHA.117.007034

Title: Early Recurrence and Major Bleeding in Patients With Acute Ischemic Stroke and Atrial Fibrillation Treated With Non-Vitamin-K Oral Anticoagulants (RAF-NOACs) Study
Author: Paciaroni, Maurizio; Agnelli, Giancarlo; Falocci, Nicola; Tsivgoulis, Georgios; Vadikolias, Kostantinos; Liantinioti, Chrysoula; Chondrogianni, Maria; Bovi, Paolo; Carletti, Monica; Cappellari, Manuel; Zedde, Marialuisa; Ntaios, George; Karagkiozi, Efstathia; Athanasakis, George; Makaritsis, Kostantinos; Silvestrelli, Giorgio; Lanari, Alessia; Ciccone, Alfonso; Putaala, Jukka; Tomppo, Liisa; Tatlisumak, Turgut; Abdul-Rahim, Azmil H.; Lees, Kennedy R.; Alberti, Andrea; Venti, Michele; Acciarresi, Monica; D'Amore, Cataldo; Becattini, Cecilia; Mosconi, Maria Giulia; Cimini, Ludovica Anna; Soloperto, Rossana; Masotti, Luca; Vannucchi, Vieri; Lorenzini, Gianni; Tassi, Rossana; Guideri, Francesca; Acampa, Maurizio; Martini, Giuseppe; Sohn, Sung-Il; Marcheselli, Simona; Mumoli, Nicola; De Lodovici, Maria Luisa; Bono, Giorgio; Furie, Karen L.; Tadi, Prasanna; Yaghi, Shadi; Toni, Danilo; Letteri, Federica; Tassinari, Tiziana; Kargiotis, Odysseas; Lotti, Enrico Maria; Flomin, Yuriy; Mancuso, Michelangelo; Maccarrone, Miriam; Giannini, Nicola; Bandini, Fabio; Pezzini, Alessandro; Poli, Loris; Padovani, Alessandro; Scoditti, Umberto; Denti, Licia; Consoli, Domenico; Galati, Franco; Sacco, Simona; Carolei, Antonio; Tiseo, Cindy; Gourbali, Vanessa; Orlandi, Giovanni; Giuntini, Martina; Chiti, Alberto; Giorli, Elisa; Gialdini, Gino; Corea, Francesco; Ageno, Walter; Bellesini, Marta; Colombo, Giovanna; Monaco, Serena; Baronello, Mario Maimone; Karapanayiotides, Theodore; Caso, Valeria
Contributor: University of Helsinki, Clinicum
University of Helsinki, HUS Neurocenter
University of Helsinki, Department of Neurosciences
Date: 2017-12
Language: eng
Number of pages: 13
Belongs to series: Journal of the American Heart Association
ISSN: 2047-9980
URI: http://hdl.handle.net/10138/231565
Abstract: Background-The optimal timing to administer non-vitamin K oral anticoagulants (NOACs) in patients with acute ischemic stroke and atrial fibrillation is unclear. This prospective observational multicenter study evaluated the rates of early recurrence and major bleeding (within 90 days) and theirtiming in patients with acute ischemic stroke and atrial fibrillation who received NOACs for secondary prevention. Methods and Results-Recurrence was defined as the composite of ischemic stroke, transient ischemic attack, and symptomatic systemic embolism, and major bleeding was defined as symptomatic cerebral and major extracranial bleeding. For the analysis, 1127 patients were eligible: 381 (33.8%) were treated with dabigatran, 366 (32.5%) with rivaroxaban, and 380 (33.7%) with apixaban. Patients who received dabigatran were younger and had lower admission National Institutes of Health Stroke Scale score and less commonly had a CHA(2)DS(2)-VASc score >4 and less reduced renal function. Thirty-two patients (2.8%) had early recurrence, and 27 (2.4%) had major bleeding. The rates of early recurrence and major bleeding were, respectively, 1.8% and 0.5% in patients receiving dabigatran, 1.6% and 2.5% in those receiving rivaroxaban, and 4.0% and 2.9% in those receiving apixaban. Patients who initiated NOACs within 2 days after acute stroke had a composite rate of recurrence and major bleeding of 12.4%; composite rates were 2.1% for those who initiated NOACs between 3 and 14 days and 9.1% for those who initiated > 14 days after acute stroke. Conclusions-In patients with acute ischemic stroke and atrial fibrillation, treatment with NOACs was associated with a combined 5% rate of ischemic embolic recurrence and severe bleeding within 90 days.
Subject: acute stroke
anticoagulants
atrial fibrillation
secondary prevention
HEALTH-CARE PROFESSIONALS
HEMORRHAGIC TRANSFORMATION
ARTERIAL TERRITORIES
WRITING COMMITTEE
EARLY MANAGEMENT
HUMAN BRAIN
TASK-FORCE
ASSOCIATION
GUIDELINES
WARFARIN
3112 Neurosciences
3124 Neurology and psychiatry
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