Single facility analysis of cardioembolic stroke with atrial fibrillation ̶ Trend over the past 7 years after the introduction of DOACs ̶

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  • 心房細動を伴う心原性脳塞栓症入院患者の単施設分析 ─ DOAC 登場後7 年間の推移─

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Abstract

<p>Background and purpose: Four direct oral anticoagulants (DOACs) can be used clinically to prevent cardioembolic stroke (CE) caused by atrial fibrillation (AF). However, the yearly changes in the proportion and outcome of CE remain unknown. We thus investigated the CE trends after the introduction of DOACs. Methods: Yearly changes of CE rate in cerebral infarction (CI) were evaluated using data from 2011 to 2017. CE (738) trends for previously prescribed antithrombotic drugs were investigated over the past 7 years. Additionally, we examined the severity of patients at the time of admission and the outcome at discharge. Results: The proportion of CE in CI decreased (p<0.01). The increase in DOACs (p<0.01) and anticoagulant prescriptions (p<0.01), the decrease in antiplatelet drug prescriptions (p<0.01) were significantly different in trend analysis over the past 7 years. Inadequate DOAC medication (poor adherence or inadequate low-dose prescription) was the problem in the last 3 years. Conclusion: The proportion of CE patients in CI decreased in 7 years after DOACs were introduced. The patients with poor adherence and inadequate low-dose DOAC prescriptions require careful attention.</p>

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