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Pain Management 2019 & Internal Medicine 2019 International Journal of Anesthesiology & Pain Medicine
ISSN: 2471-982X Page 45
JOINT EVENT
7th Edition of International Conference on
Pain Management
8th Edition of International Conference on
Internal Medicine &
Patient Care
&
March 25-26, 2019
Rome, Italy
Recurrence of stroke in patients with AF using NOACs
Yasushi Ueno
Shinko Memorial Hospital, Japan
Objective: To evaluate the risk factors of
recurrent thromboembolic cerebral infarction in patients
with non-valvular atrial fibrillation (NVAF), who were
treated with non-vitamin K antagonist oral anticoagulants
(NOACs).
Methods: The data of patients collected from the
database of our institute for about 3 years (between 2013
April to 2015 December).
Results: We analysed 16 patient’s data ( 14 male, 2
female, median age 67.0 years) in whom recurrent
thromboembolic cerebral infarction occurred despite
receiving NOACs. In 14 of 16 patients with recurrent
ischemic stroke, received reduced dose drug and in 10
of 14 patient with reduced dose drug, inappropriate
dose setting (that is out of drug dose criteria of NOACs)
has been selected by the physicians or practitioner
concerning about the risk for intracranial hemorrhage and
patient’s age. After we have changed to the appropriate
dose, recurrence of thromboembolic cerebral infarction
was not observed. More than 70% of recurrent cerebral
infarction occurred in patients with inappropriate under-
dose use of NOACs.
Conclusions: This paper demonstrates that patients with
inappropriate reduced dose selection of NOACs carries
a significant risk of recurrent thromboembolic cerebral
infarction despite treated with NOACs anticoagulation,
highlighting the need for appropriate drug dose selection
for stroke prevention in real world NVAF patients.
Biography
Yasushi Ueno has his expertise in neurosurgery and stroke
prevention. Especially he has a lot of clinical data about acute
ischemic stroke and vascular recanalization flowing medical
preservation using DOACs (direct oral anticoagulants). He
has built this clinical data after years of experience in bed side
work, research, evaluation, and administration both in Shinko
hospital and education institutions; Kyoto University.
Yasushi Ueno, Int J Anesth Pain Med 2019, Volume 5
DOI: 10.21767/2471-982X-C1-006