International Journal of Anesthesiology & Pain Medicine

Recurrence of stroke in patients with AF using NOACs

Joint Event on 7^th Edition of International Conference on Pain Management & 8^th Edition of International Conference on Internal Medicine & Patient Care
March 25-26, 2019 Rome, Italy

Yasushi Ueno

Shinko Memorial Hospital, Japan

Posters & Accepted Abstracts: Int J Anesth Pain Med

DOI: 10.21767/2471-982X-C1-006

Abstract

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 underdose 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.

E-mail: yweno@hotmail.co.jp