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Acta medica Croatica : Časopis Akademije medicinskih znanosti Hrvatske, Vol. 69 No. 2, 2015.

Original scientific paper

THROMBOPROPHYLAXIS IN PATIENTS WITH NONVALVULAR ATRIAL FIBRILLATION ADMITTED IN UNIVERSITY HOSPITAL SPLIT, CROATIA, DUE TO THE ISCHAEMIC STROKE IN RELATION TO THROMBOEMBOLIC AND BLEEDING RISK

IVANA CVITKOVIĆ orcid id orcid.org/0000-0002-4199-3905 ; Outpatient Cardiology Clinic, Split, Croatia
IVONA BOŽIĆ ; Outpatient Cardiology Clinic, Split, Croatia
VEDRAN CAREVIĆ ; Department of Cardiology, University Hospital Split, Split, Croatia
KREŠIMIR ČALJKUŠIĆ ; Department of Neurology, University Hospital Split, Split, Croatia
ANTON MAROVIĆ ; Department of Neurology, University Hospital Split, Split, Croatia
IVO LUŠIĆ ; Department of Neurology, University Hospital Split, Split, Croatia
DAMIR FABIJANIĆ ; Department of Cardiology, University Hospital Split, Split, Croatia

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Abstract

Aim of the study was to assess the concordance of the thromboprophylactic treatment in patients with nonvalvular atrial ibrillation (nAF) at the time of admission due to ischemic stroke with clinical guidelines of the European Society of Cardiology. Methods: In the cross-sectional study were included 327 patients [143 (44%) males] treated because of ischemic stroke associated with nAF. The index of the thromboembolic risk (TE) has been established by the CHA2DS2-VASc score, whereas the bleeding risk has been assessed by the HAS-BLED score. Results: Before the ischemic stroke, 98.2% of patients belonged to the group of high TE risk. Among these patients only 179 (55%) were received thromboprophylaxis: 67.5% patients acetylsalicylic acid, 30.5% warfarin, and 4% clopidogrel. Previous ischemic stroke was independently correlated with warfarin administration (OR 2.5; 95% CI 1.4-4.5; p=0.003), while poorly controlled arterial hypertension was independently correlated with warfarin non-administration (OR 0.47; 95% CI 0.25-0.88; p=0.019). The 83.7% of 55 patients, who experienced ischemic stroke during anticoagulant treatment, had an INR values lower than therapeutic. Conclusion: Thromboprophylaxis among the patients with nAF admitted because of ischemic stroke did not correlate with their TE risk and contemporary guidelines of the European Society of Cardiology.

Keywords

stroke; atrial ibrillation; anticoagulant therapy; thromboprophylaxis

Hrčak ID:

147980

URI

https://hrcak.srce.hr/147980

Publication date:

4.11.2015.

Article data in other languages: croatian

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