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スダ サトシ
SUDA Satoshi
須田 智 所属 埼玉医科大学 医学部 国際医療センター 神経内科・脳卒中内科 職種 教授 |
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| 論文種別 | 学術雑誌(原著) |
| 言語種別 | 英語 |
| 査読の有無 | 査読なし |
| 表題 | Sustained atrial fibrillation is related to a higher severity of stroke in patients taking direct oral anticoagulants |
| 掲載誌名 | 正式名：Journal of the Neurological Sciences ISSNコード：0022-510X |
| 掲載区分 | 国外 |
| 出版社 | Elsevier BV |
| 巻・号・頁 | 434,120172-120172頁 |
| 著者・共著者 | Toshiyuki Hayashi,Satoshi Suda,Arata Abe,Yasuyuki Iguchi,Yoshiki Yagita,Takao Kanzawa,Seiji Okubo,Shigeru Fujimoto,Kazumi Kimura |
| 発行年月 | 2022/01 |
| 概要 | BACKGROUND: Atrial fibrillation (AF) includes paroxysmal and sustained (persistent or permanent) AF, and both forms are considered risk factors for ischemic stroke. This study aimed to investigate the differences in stroke severity at admission between patients with paroxysmal AF and sustained AF when treated with direct oral anticoagulants (DOACs). METHODS: Using data from DOAC-treated 300 nonvalvular patients with AF and acute anterior circulation stroke who were registered in the Multicenter Prospective Analysis of Stroke Patients Taking Oral Anticoagulants study, patients were divided into two groups, namely, paroxysmal AF and sustained AF. We compared the clinical characteristics between the two groups and determined the effect of these two types of AF on stroke severity on admission. RESULTS: Of 300 patients, 246 (males, n = 149; median age, 80 years) and 54 (males, n = 32; median age, 78 years) were assigned to the sustained AF and paroxysmal AF groups, respectively. The sustained AF group had a higher proportion of severe stroke (National Institutes of Health Stroke Scale score, >20) on admission (22.0% vs. 5.7%, p = 0.006) and internal carotid artery occlusion (11.4% vs. 1.9%, p = 0.03) compared to the paroxysmal AF group. Multivariate analysis showed that sustained AF was independently associated with severe stroke on admission (odds ratio 4.31, 95% confidence interval 1.24-15.0, p = 0.02). CONCLUSIONS: Sustained AF was associated with a higher severity of stroke accompanied with major vessel occlusion than paroxysmal AF, even prior to DOACs treatment. Registration https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000034958. |
| DOI | 10.1016/j.jns.2022.120172 |
| PMID | 35176560 |