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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 | 査読あり |
| 表題 | Ischemic stroke during anticoagulant interruption by healthcare professionals in stroke patients with atrial fibrillation. |
| 掲載誌名 | 正式名：Journal of the neurological sciences ISSNコード：0022-510X |
| 掲載区分 | 国外 |
| 巻・号・頁 | 400,113-118頁 |
| 著者・共著者 | Yuki Sakamoto,Seiji Okubo,Chikako Nito,Yasuhiro Nishiyama,Satoshi Suda,Noriko Matsumoto,Junya Aoki,Takashi Shimoyama,Takuya Kanamaru,Kanako Muraga,Kentaro Suzuki,Masahiro Mishina,Kazumi Kimura |
| 発行年月 | 2019/05/15 |
| 概要 | BACKGROUND: Anticoagulant therapy often requires temporary interruption. Nevertheless, the frequency and clinical characteristics of stroke patients who develop stroke during anticoagulant interruption are not fully known. METHODS: From March 2011 through May 2017, consecutive acute ischemic stroke patients with AF who were admitted to our stroke unit were retrospectively recruited. Patients who developed ischemic stroke during anticoagulant interruption were defined as those who developed ischemic stroke within 30 days from anticoagulant interruption. The frequency and clinical characteristics of patients during anticoagulant interruption were analyzed. RESULTS: A total of 561 patients with AF and acute ischemic stroke (237 women; median age 78 [IQR 71-85] years) were admitted during the study period. Of these, 21 (3.7%, 12 patients discontinued vitamin K antagonist [VKA] and 9 discontinued direct oral anticoagulants [DOACs]) patients were admitted during the period of anticoagulant interruption. Severity and functional outcomes in stroke patients during anticoagulant interruption were not different from those without anticoagulant treatment. The number of days between anticoagulant interruption and stroke onset was shorter in patients who discontinued DOACs (3 [3-5] days) than in those who discontinuedVKAs (10 [7-20] days, p = .004). The major reason for interruption was planning of invasive procedures (52%). Guideline deviations were suspected in 82% of such cases. CONCLUSION: Patients developing stroke during anticoagulant interruption accounted for 3.7% of stroke patients with AF. Strokes occurred relatively early after interruption, especially in patients who discontinued DOACs. Guideline deviations was frequent. |
| DOI | 10.1016/j.jns.2019.03.018 |
| PMID | 30925358 |