Prestroke and poststroke oral anticoagulation therapy in AF patients

Bottom Line: Oral anticoagulation therapy after stroke in patients with atrial fibrillation was associated with lower risk for recurrent blood vessel-blocking blood clots.

Why The Research Is Interesting: Patients with atrial fibrillation (abnormal heart rhythm) are at increased risk of ischemic stroke and oral anticoagulation therapy (OAC) can reduce that risk. Underse of OAC has been reported in both Europe and the United States.

Who and When: 30,626 Danish patients with atrial fibrillation admitted with ischemic stroke (when a blood clot blocks a blood vessel to the brain)

What (Study Measures): Patients who survived 100 days after discharge were divided into three groups according to poststroke antithrombotic therapy (OAC, antiplatelet therapy alone or no antithrombotic therapy) with data on hospital admission, prescription fillings and vital status coming from nationwide registries (exposures); thromboembolic events (blood vessel-blocking blood clots) and bleeding complications across the three groups (outcomes)

How (Study Design): This was an observational study. Researchers were not intervening for purposes of the study and they cannot control natural differences that could explain study findings.

Authors: Anna Gundlund, M.D., of Herlev and Gentofte Hospital, Denmark, and coauthors

Study Limitations: Registries didn't include factors such as alcohol consumption or fall tendency; possible misclassification of ischemic stroke; results may have been skewed by patient compliance with medications; all types of AF included in study, which could have influenced physician's choice of antithrombotic therapy

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