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
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	Characteristics of Ischemic Versus Hemorrhagic Stroke in Patients Receiving Oral Anticoagulants: Results of the PASTA Study.
掲載誌名	正式名：Internal medicine (Tokyo, Japan)
掲載区分	国内
巻・号・頁	61(6),801-810頁
著者・共著者	Satoshi Suda,Arata Abe,Yasuyuki Iguchi,Yoshiki Yagita,Takao Kanzawa,Seiji Okubo,Nobuyuki Ohara,Takayuki Mizunari,Mineo Yamazaki,Nobuhito Nakajima,Kimito Kondo,Shigeru Fujimoto,Takeshi Inoue,Takeshi Iwanaga,Yuka Terasawa,Kensaku Shibazaki,Yu Kono,Makoto Nakajima,Masataka Nakajima,Masahiro Mishina,Koji Adachi,Ichiro Imafuku,Koichi Nomura,Takehiko Nagao,Hiroshi Yaguchi,Sadahisa Okamoto,Masato Osaki,Kazumi Kimura
発行年月	2021/09/04
概要	Objective Limited data exist regarding the comparative detailed clinical characteristics of patients with ischemic stroke (IS)/transient ischemic attack (TIA) and intracerebral hemorrhage (ICH) receiving oral anticoagulants (OACs). Methods The prospective analysis of stroke patients taking oral anticoagulants (PASTA) registry, a multicenter registry of 1,043 stroke patients receiving OACs (vitamin K antagonists [VKAs] or non-vitamin K oral antagonists [NOACs]) across 25 medical institutions throughout Japan, was used. Univariate and multivariable analyses were used to analyze differences in clinical characteristics between IS/TIA and ICH patients with atrial fibrillation (AF) who were registered in the PASTA registry. Results There was no significant differences in cardiovascular risk factors, such as hypertension, diabetes mellitus, dyslipidemia, smoking, or alcohol consumption (all p>0.05), between IS/TIA and ICH among both NOAC and VKA users. Cerebral microbleeds (CMBs) (odds ratio [OR], 4.77; p<0.0001) were independently associated with ICH, and high brain natriuretic peptide/N-terminal pro B-type natriuretic peptide levels (OR, 1.89; p=0.0390) were independently associated with IS/TIA among NOAC users. A history of ICH (OR, 13.59; p=0.0279) and the high prothrombin time-international normalized ratio (PT-INR) (OR, 1.17; p<0.0001) were independently associated with ICH, and a history of IS/TIA (OR, 3.37; 95% CI, 1.34-8.49; p=0.0101) and high D-dimer levels (OR, 2.47; 95% CI, 1.05-5.82; p=0.0377) were independently associated with IS/TIA among VKA users. Conclusion The presence of CMBs, a history of stroke, natriuretic peptide and D-dimer levels, and PT-INR may be useful for risk stratification of either IS/TIA or ICH development in patients with AF receiving OACs.
DOI	10.2169/internalmedicine.8113-21
PMID	34483213