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Rad Croatian Academy of Sciences and Arts. Medical sciences : Medical Sciences, Vol. 559 No. 64-65, 2023.

Original scientific paper

https://doi.org/10.21857/moxpjh1w2m

Anticoagulant therapy in secondary stroke prevention in patients with atrial fibrillation

Maja Petrovska ; PHO Clinical hospital Bitola, Bitola, N. Macedonia
Aleksandra Trajcheska Stojanovska orcid id orcid.org/0009-0000-5983-1229 ; PHO General hospital Prilep, Prilep, N. Macedonia
Glorija Gashpar orcid id orcid.org/0009-0009-3671-2644 ; PHI Specialized Hospital for Geriatric and Palliative Medicine "13th November", Bitola, N. Macedonia
Anita Arsovska orcid id orcid.org/0000-0003-1927-9614 ; University Clinic of Neurology, Faculty of Medicine, “Ss. Cyril and Methodius” University, Skopje, N. Macedonia

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Abstract

Background: Atrial fibrillation (AF) is one of the most important risk factors for ischemic stroke. It is not completely known whether ischemic stroke patients with AF that use oral anticoagulant therapy are at increased risk for further recurrent strokes or how ongoing secondary prevention should be managed. The aim of this study is to determine the role of anticoagulant therapy in secondary stroke prevention in patients with AF.
Materials and Methods: A retrospective analysis was made of 98 patients with acute stroke and AF hospitalized at the University Clinic for Neurology in Skopje, N. Macedonia at the Department of Urgent Neurology in the period from 2019 to 2022. Inclusion criteria for the study were patients with AF, in all age groups, diagnosed with stroke. In the analysis, we also included other parameters such as neurological deficit quantified by NIHSS (National Institutes of Health Stroke Scale), state of consciousness quantified by GCS (Glasgow Coma Scale/Score) and degree of disability quantified by mRS (Modified Rankin Scale).
Results: The results of this study showed that group 1A (known AF) patients had a predominance of moderate to severe stroke (quantified by NIHSS score), moderate disability (quantified by mRS score), low GCS score, compared to group 1B (newly diagnosed AF) patients with a predominance of mild stroke, mild disability, but without proven statistical significance (p>0.05). It was also found that even though the patients were treated with anticoagulant therapy, they still had developed a stroke.
Conclusion In this study, it was concluded that patients, despite receiving anticoagulant therapy, still had developed a stroke. It might be related with incompliance, reduced pharmacological efficacy of the anticoagulant in individual patients, or other factors such as alternative stroke mechanisms (eg, small vessel occlusion). Regular monitoring and good patient education are important for successful treatment.

Keywords

atrial fibrillation; stroke; anticoagulant therapy; secondary prevention

Hrčak ID:

312713

URI

https://hrcak.srce.hr/312713

Publication date:

22.12.2023.

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