Prior Anticoagulation and Short‐ or Long‐Term Clinical Outcomes in Ischemic Stroke or Transient Ischemic Attack Patients With Nonvalvular Atrial Fibrillation
Authors:
- Keisuke TokunagaKTKeisuke Tokunaga
- Masatoshi KogaMKMasatoshi Koga
- Ryo ItabashiRIRyo Itabashi
- Hiroshi YamagamiHYHiroshi Yamagami
- Kenichi TodoKTKenichi Todo
- Sohei YoshimuraSYSohei Yoshimura
- Kazumi KimuraKKKazumi Kimura
- Shoichiro SatoSSShoichiro Sato
- Tadashi TerasakiTTTadashi Terasaki
- Manabu InoueMIManabu Inoue
- Yoshiaki ShiokawaYSYoshiaki Shiokawa
Open Access
- 5 February 2019
- journal article
- research article
- Published by Wolters Kluwer Health in Journal of the American Heart Association
- Vol. 8 (3) , e010593
Abstract
Background: We aimed to clarify associations between prior anticoagulation and short‐ or long‐term clinical outcomes in ischemic stroke or transient ischemic attack patients with nonvalvular atrial fibrillation. Methods and Results: A total of 1189 ischemic stroke or transient ischemic attack patients with nonvalvular atrial fibrillation who were hospitalized within 7 days after onset were analyzed. Of these, 813 patients (68.4%) received no prior anticoagulation, 310 (26.1%) received prior warfarin treatment with an international normalized ratio ( INR ) P =0.001; INR ≥2: adjusted odds ratio: 0.40; 95% CI, 0.16–0.97; P =0.043) but was not associated with a lower risk of death or disability at 2 years. Prior warfarin treatment with an INR ≥2 on admission was associated with a higher risk of ischemic events within 2 years compared with no prior anticoagulation (adjusted hazard ratio: 2.94; 95% CI, 1.20–6.15; P =0.021). Conclusions: Prior warfarin treatment was associated with a lower risk of death or disability at 3 months but was not associated with a lower risk of death or disability at 2 years in ischemic stroke or transient ischemic attack patients with nonvalvular atrial fibrillation. Prior warfarin treatment with an INR ≥2 on admission was associated with a higher risk of ischemic events within 2 years. Clinical Trial Registration: URL : http://www.clinicaltrials.gov . Unique identifier: NCT 01581502.Keywords
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