Asako Nakamura

EAFT (European Atrial Fibrillation Trial) Study Group

Hiroshi Sugimori

Jun Hata

Junya Kuroda

Masahiro Kamouchi

Ryu Matsuo

Takahiro Kuwashiro

Takanari Kitazono

Tetsuro Ago


            Background and Purpose—
            The relationship between the intensity of anticoagulation at the onset of acute cardioembolic stroke and clinical outcome after stroke is unclear. Here, we elucidated the relationship between prothrombin time–international normalized ratio (PT-INR) values on admission and clinical outcomes in patients with acute cardioembolic stroke.
          
          
            Methods—
            A total of 602 patients from the Fukuoka Stroke Registry in Japan who had been treated with warfarin but developed cardioembolic stroke were enrolled. The patients were classified into 3 groups according to their PT-INR values on admission: PT-INR &lt;1.50, 411 patients; PT-INR 1.50 to 1.99, 146 patients; and PT-INR ≥2.00, 45 patients. The associations between PT-INR categories and severe neurological deficits (National Institutes of Health Stroke Scale ≥10) on admission and poor functional outcome (modified Rankin scale 4–6) at discharge were investigated using a logistic regression analysis.
          
          
            Results—
            Neurological deficits on admission were less severe, and functional outcome at discharge was more favorable as the PT-INR level on admission increased. The multivariate analysis revealed that severe neurological deficits were inversely associated with PT-INR on admission (PT-INR 1.50–1.99: odds ratio, 0.66; 95% confidence interval, 0.43–1.00; PT-INR ≥2.00: odds ratio, 0.41; 95% confidence interval, 0.20–0.83; compared with a reference group of PT-INR &lt;1.50). Poor functional outcome was less likely in patients with PT-INR ≥2.00 (odds ratio, 0.20; 95% confidence interval, 0.06–0.55) after adjustment for confounders.
          
          
            Conclusions—
            Prestroke PT-INR ≥2.0 is associated with favorable clinical outcomes after acute cardioembolic stroke.
          </jats:sec

Crossref

Stroke

Intensity of Anticoagulation and Clinical Outcomes in Acute Cardioembolic Stroke

Intensity of Anticoagulation and Clinical Outcomes in Acute Cardioembolic Stroke

Abstract

Similar works

Full text

Available Versions

Crossref