Clinical Features of Ischemic Stroke during Treatment with Dabigatran: An Association between Decreased Severity and a Favorable Prognosis
-
- Hayashi Takeshi
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Japan
-
- Kato Yuji
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Japan
-
- Fukuoka Takuya
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Japan
-
- Deguchi Ichiro
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Japan
-
- Maruyama Hajime
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Japan
-
- Horiuchi Yohsuke
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Japan
-
- Sano Hiroyasu
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Japan
-
- Nagamine Yuito
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Japan
-
- Mizuno Satoko
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Japan
-
- Tanahashi Norio
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Japan
この論文をさがす
抄録
Objective Anticoagulation therapy with warfarin is associated with a favorable prognosis in ischemic stroke. Dabigatran, a new oral anticoagulant, is widely used to prevent ischemic stroke in non-valvular atrial fibrillation (NVAF) patients. However, its association with decreased severity and a favorable prognosis once ischemic stroke has occurred remains unknown.<br> Methods We retrospectively reviewed all the patients with NVAF-associated ischemic stroke admitted to our hospital from April 2011 to December 2014 and included those who received dabigatran therapy. We assessed whether the patients were under regular use of the drug or discontinuance and classified them into 2 groups, the treatment and discontinuation groups. Clinical data, including the age, sex, ASCOD stroke phenotype, NVAF type, prescribed drug dose, comorbidities, CHADS2 score, renal function, National Institute of Health Stroke Scale (NIHSS) score on admission, modified Rankin scale (mRS) score at discharge, D-dimer, and brain natriuretic peptide, were investigated and compared between the groups.<br> Results Nine patients were under regular dabigatran therapy, and 6 were under discontinuance of the drug. The age, sex, ASCOD stroke phenotype, NVAF type, comorbidities, renal function, and CHADS2 scores did not differ between the 2 groups; however, the NIHSS scores were significantly lower in the treatment group. The mRS scores at discharge were additionally decreased in the treatment group. Moreover, the D-dimer scores were lower in the treatment group, thus suggesting a possible role in the decreased stroke severity.<br> Conclusion Dabigatran may therefore decrease the severity of ischemic stroke, even if ischemic stroke occurs.<br>
収録刊行物
-
- Internal Medicine
-
Internal Medicine 54 (19), 2433-2437, 2015
一般社団法人 日本内科学会
