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Title: Functional outcomes of ischaemic stroke patients with known Atrial Fibrillation not on therapeutic anticoagulation
Authors: Nagaratnam, Sai Adithya ;Edwards, Leon S ;Blair, Christopher ;Evans, James W ;O'Brien, Bill 
Affliation: Central Coast Local Health District
Gosford Hospital
Issue Date: 5-Mar-2023
Source: Online ahead of print
Journal title: Internal Medicine Journal
Department: Neurology
Abstract: Anticoagulation significantly reduces the risk of ischaemic stroke in patients with atrial fibrillation (AF). There are a proportion of patients with known AF who remain off anticoagulation. This study aims to retrospectively compare the baseline characteristics, treatments and functional outcomes between patients with ischaemic stroke and known atrial fibrillation based on their anticoagulation status. A single centre, retrospective review of consecutive patients with an ischaemic stroke and a known history of AF was conducted RESULTS: 204 patients with an ischaemic stroke had documented AF prior to the index admission, of which 126 were anticoagulated. Median admission NIHSS score was lower for anticoagulated patients, though not statistically significant (5.1 vs 7.0 p= 0.09). Median baseline mRS did not significantly differ. Non-anticoagulated patients were more likely to have large vessel occlusions (37.2% vs 23.8%, p=0.04) and more likely to receive intravenous thrombolysis (15.4% versus 1.6%, p<0.01). There was no difference in rates of endovascular clot retrieval between groups (p>0.05). Unfavourable functional outcome at 90 days (mRS >= 3) did not significantly differ between groups (p=0.51). 38.5% of non-anticoagulated patients had no documented reason for this. Of the patients who survived the index admission 81.5% of patients who were not anticoagulated on admission received anticoagulation. Baseline anticoagulation was associated with milder stroke severity patients with known AF and an ischaemic stroke. There was no significant difference in functional outcomes at 90 days between groups. Larger observational studies are required to further assess this cohort. This article is protected by copyright. All rights reserved.
DOI: 10.1111/imj.16044
Publicaton type: Journal Article
Keywords: Neurology
Appears in Collections:Neurology

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