Direct oral anticoagulants in the early phase of non valvular atrial fibrillation-related acute ischemic stroke: focus on real life studies.
Administration, Oral
Aged
Aged, 80 and over
Anticoagulants
/ administration & dosage
Atrial Fibrillation
/ diagnosis
Brain Ischemia
/ diagnosis
Drug Administration Schedule
Female
Hemorrhage
/ chemically induced
Humans
Ischemic Attack, Transient
/ diagnosis
Male
Middle Aged
Recurrence
Risk Factors
Secondary Prevention
/ methods
Stroke
/ diagnosis
Time Factors
Treatment Outcome
Apixaban
Dabigatran
Direct oral anticoagulants
Edoxaban
Rivaroxaban
Stroke
Journal
Journal of thrombosis and thrombolysis
ISSN: 1573-742X
Titre abrégé: J Thromb Thrombolysis
Pays: Netherlands
ID NLM: 9502018
Informations de publication
Date de publication:
Feb 2019
Feb 2019
Historique:
pubmed:
25
11
2018
medline:
18
6
2019
entrez:
25
11
2018
Statut:
ppublish
Résumé
Strong evidence for the use of direct oral anticoagulants (DOACs) in the early phase of non valvular atrial fibrillation (NVAF)-related acute ischemic stroke (AIS) is lacking, because this kind of patients were excluded from phase III randomized clinical trials (RCT) and ad hoc RCTs are ongoing. In the latest years a lot of real life studies on this topic have been published. The aim of our review was to focus on these. We reviewed the PubMed databases searching articles reporting on DOACs starting time within 2 weeks from AIS onset. We selected fifteen studies, eight with retrospective, six with prospective observational and one with a prospective, open-label, single arm design. Overall, 2920 patients (47.8% females) were included. In twelve studies median or mean age of patients was over 75 years. Mean or median NIHSS ad hospital admission was ≤ 12 in all studies. About one-third of patients (32.4%) received urgent reperfusion by systemic thrombolysis or mechanical thrombectomy. About one-fifth of patients (22.8%) had large infarct size. Median starting time of DOACs was reported in thirteen studies and it ranged from 2 to 8 days. About one-half of patients (45.9%) received a low dose of DOACs. In studies reporting on median or mean CHA
Identifiants
pubmed: 30470967
doi: 10.1007/s11239-018-1775-2
pii: 10.1007/s11239-018-1775-2
doi:
Substances chimiques
Anticoagulants
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
292-300Références
Ann Intern Med. 2007 Jun 19;146(12):857-67
pubmed: 17577005
N Engl J Med. 2009 Sep 17;361(12):1139-51
pubmed: 19717844
N Engl J Med. 2011 Sep 8;365(10):883-91
pubmed: 21830957
N Engl J Med. 2011 Sep 15;365(11):981-92
pubmed: 21870978
J Neurol Sci. 2013 Aug 15;331(1-2):90-3
pubmed: 23743245
N Engl J Med. 2013 Nov 28;369(22):2093-104
pubmed: 24251359
Eur J Neurol. 2015 Jul;22(7):1048-55
pubmed: 25319957
Circ J. 2015;79(4):862-6
pubmed: 25736910
Rev Neurol (Paris). 2015 Sep;171(8-9):613-5
pubmed: 25857461
Stroke. 2015 Aug;46(8):2175-82
pubmed: 26130094
Int J Stroke. 2016 Jul;11(5):565-74
pubmed: 26927811
J Stroke Cerebrovasc Dis. 2016 Jun;25(6):1342-8
pubmed: 26987488
J Thromb Thrombolysis. 2016 Nov;42(4):453-62
pubmed: 27207691
Stroke. 2016 Jul;47(7):1917-9
pubmed: 27222524
J Thromb Thrombolysis. 2016 Oct;42(3):393-8
pubmed: 27329483
J Stroke Cerebrovasc Dis. 2016 Sep;25(9):2317-21
pubmed: 27449113
Neurology. 2016 Nov 1;87(18):1856-1862
pubmed: 27694266
Circ J. 2017 Jan 25;81(2):180-184
pubmed: 27980235
Int J Stroke. 2017 Aug;12(6):589-596
pubmed: 28730948
JAMA Neurol. 2017 Oct 1;74(10):1206-1215
pubmed: 28892526
J Stroke Cerebrovasc Dis. 2018 Jan;27(1):76-82
pubmed: 28918086
J Am Heart Assoc. 2017 Nov 29;6(12):null
pubmed: 29220330
Stroke. 2018 Mar;49(3):e46-e110
pubmed: 29367334
Eur Heart J. 2018 Apr 21;39(16):1330-1393
pubmed: 29562325
Circ J. 2018 Jun 25;82(7):1935-1942
pubmed: 29863095
Geriatr Gerontol Int. 2018 Aug;18(8):1304-1305
pubmed: 30136389