Version 1
: Received: 4 November 2024 / Approved: 5 November 2024 / Online: 5 November 2024 (08:56:54 CET)
How to cite:
Seetge, J.; Cséke, B.; Karádi, Z. N.; Bosnyák, E.; Szapáry, L. Beyond Anticoagulation: Limitations of Oral Anticoagulants in Preventing Stroke Recurrence in Atrial Fibrillation. Preprints2024, 2024110280. https://doi.org/10.20944/preprints202411.0280.v1
Seetge, J.; Cséke, B.; Karádi, Z. N.; Bosnyák, E.; Szapáry, L. Beyond Anticoagulation: Limitations of Oral Anticoagulants in Preventing Stroke Recurrence in Atrial Fibrillation. Preprints 2024, 2024110280. https://doi.org/10.20944/preprints202411.0280.v1
Seetge, J.; Cséke, B.; Karádi, Z. N.; Bosnyák, E.; Szapáry, L. Beyond Anticoagulation: Limitations of Oral Anticoagulants in Preventing Stroke Recurrence in Atrial Fibrillation. Preprints2024, 2024110280. https://doi.org/10.20944/preprints202411.0280.v1
APA Style
Seetge, J., Cséke, B., Karádi, Z. N., Bosnyák, E., & Szapáry, L. (2024). Beyond Anticoagulation: Limitations of Oral Anticoagulants in Preventing Stroke Recurrence in Atrial Fibrillation. Preprints. https://doi.org/10.20944/preprints202411.0280.v1
Chicago/Turabian Style
Seetge, J., Edit Bosnyák and László Szapáry. 2024 "Beyond Anticoagulation: Limitations of Oral Anticoagulants in Preventing Stroke Recurrence in Atrial Fibrillation" Preprints. https://doi.org/10.20944/preprints202411.0280.v1
Abstract
Background/Objectives: Despite the widespread use of oral anticoagulants (OACs), acute ischemic stroke (AIS) remains a significant risk for patients with atrial fibrillation (AF). The real-world effectiveness of OACs in preventing recurrent strokes, particularly following an initial stroke of cardioembolic (CE) origin, continues to be a major challenge for clinicians managing AF patients. This study evaluates the efficacy of OACs in secondary stroke prevention and investigates the influence of anticoagulation type and quality on recurrence risk. Methods: We analyzed data from 128 AF patients in the prospective Transzlációs Idegtudományi Nemzeti Laboratórium (TINL) STROKE-registry, admitted with CE stroke between February 2023 and September 2024. Patients were categorized by anticoagulation status at admission (OAC-users, n = 89; anticoagulation-naïve, n = 39). Recurrence rates were assessed using logistic regression models, adjusted for age, sex, hypertension, diabetes, and pre-stroke disability. Subgroup analyses explored the effects of anticoagulation type and quality. Results: Recurrence rates were similar between OAC-treated and anticoagulation-naïve patients after adjusting for confounders (19.10% vs. 17.95%, p = 0.870). Among anticoagulated patients, neither anticoagulation type nor quality alone significantly influenced recurrence risk. However, their interaction was statistically significant (p = 0.049), suggesting that the effectiveness of anticoagulation in preventing strokes is strongly affected by treatment quality. Conclusions: Although OACs are a cornerstone of stroke prevention in patients with AF, their efficacy in reducing recurrence depends on optimal management. These findings highlight that adequate anticoagulation, not just its use, is critical to minimize recurrence risk. To effectively prevent strokes in high-risk AF patients, future strategies must focus on standardized protocols, tailored monitoring, and individualized dosing regimens.
Medicine and Pharmacology, Neuroscience and Neurology
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
