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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 | Insufficient warfarin therapy is associated with higher severity of stroke than no anticoagulation in patients with atrial fibrillation and acute anterior-circulation stroke |
| 掲載誌名 | 正式名：Circulation Journal ISSNコード：1347-4820 |
| 出版社 | Japanese Circulation Society |
| 巻・号・頁 | 82(5),1437-1442頁 |
| 著者・共著者 | Yuki Sakamoto,Seiji Okubo,Chikako Nito,Satoshi Suda,Noriko Matsumoto,Yasuhiro Nishiyama,Junya Aoki,Takashi Shimoyama,Takuya Kanamaru,Kentaro Suzuki,Masahiro Mishina,Kazumi Kimura |
| 発行年月 | 2018 |
| 概要 | Background: Insufficient anticoagulant intensity on admission is common in stroke patients with atrial fibrillation (AF) on vitamin K antagonist (VKA) therapy. Nevertheless, the effects of VKA under-treatment on stroke severity or arterial occlusion are not well known. The aim of the present study was to investigate the relationship between insufficient VKA therapy and stroke severity, or the site of arterial occlusion in patients with acute ischemic stroke (AIS) and AF. Methods and Results: From March 2011 through July 2016, 446 consecutive patients with AF and AIS were recruited. Of the 446 patients, 364 (167 women median age, 79 years IQR, 71–86 years) with anterior-circulation stroke were assessed to investigate the effects of insufficient VKA. Of these, 281 were on no anticoagulant, 53 were undertreated with a VKA, and 30 were sufficiently treated with VKA on admission (PT-INR ≥2.0 for patients < 70 years and PT-INR ≥1.6 for ≥70 years old). On multivariate analysis, insufficient VKA was independently associated with severe stroke (i.e., initial NIHSS score ≥10 OR, 2.70, P=0.022) and higher prevalence of proximal artery occlusion (OR, 1.91 P=0.039) compared with no anticoagulant therapy. Conclusions: Insufficient VKA therapy on admission was associated with higher severity of stroke and higher prevalence of proximal artery occlusion in patients with AF and acute anterior-circulation stroke compared with no anticoagulant medication. |
| DOI | 10.1253/circj.CJ-17-1110 |
| PMID | 29269702 |