Anticoagulation After Ischemic Stroke or Transient Ischemic Attack (TIA) in the Time of Direct Oral Anticoagulation (DOAC) and Thrombectomy
| Autor: | Eduardo Guizan Corrales, Radhan Gopalani, Felipe De Los Rios La Rosa, Claudia Martin Diaz, Jonathan Kline, Starlie Belnap, Sylvia Marrero |
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| Rok vydání: | 2021 |
| Předmět: |
acute ischemic stroke
medicine.medical_specialty medicine.drug_class therapeutic anticoagulation endovascular thrombectomy Interquartile range Internal medicine medicine Clinical endpoint cardiovascular diseases Stroke thrombolytic therapy Transient ischemic attack (TIA) business.industry Anticoagulant General Engineering Atrial fibrillation Guideline medicine.disease Quality Improvement atrial fibrillation management Neurology direct oral anticoagulant therapy Apixaban Other business medicine.drug |
| Zdroj: | Cureus |
| ISSN: | 2168-8184 |
| DOI: | 10.7759/cureus.17392 |
| Popis: | Objective To assess anticoagulation (AC) timing and appropriateness in patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA) due to atrial fibrillation (AF) in a predominantly Hispanic community hospital in the era of direct oral AC (DOAC) and endovascular thrombectomy (EVT). Methods Adult patients presenting with known or new-onset AF and primary diagnosis of AIS/TIA admitted to Baptist Hospital of Miami between January 2018 and January 2019 were included. AC appropriateness was determined on medical history and concordance with American Heart Association AHA/American Stroke Association (ASA) AC guidelines. Median time from AIS/TIA diagnosis to AC initiation was the primary endpoint. AC guideline concordance on admission and at discharge, discordant justification, and AC selection were secondary endpoints. Results The sample included 120 patients. AC initiation was five days (interquartile range (IQR) 2-9) following AIS/TIA. Patients’ receiving intravenous (IV) alteplase experienced a 1.4-day delay in AC initiation (x̅=5.44, SE=1.05, p |
| Databáze: | OpenAIRE |
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