Abstract
Background and Aims
Patients with intracerebral haemorrhage (ICH) and atrial fibrillation (AF) have a high risk of recurrent ischemic stroke with a number of randomized controlled trials currently underway to identify optimal secondary preventive measures. Using two well-established population-based stroke registers, we describe characteristics and natural course of ICH patients with comorbid AF who are on oral anticoagulation (OAC) and no oral anticoagulation (noOAC) prior-to-stroke.
Methods
Data from the South London Stroke Register (SLSR) and the Erlangen Stroke Project (ESPro) from 1998 to 2020 were analysed. ICH patients with comorbid AF were grouped by pre-stroke use of OAC. Kaplan-Meier estimates of case-fatality and recurrence rates were applied.
Results
85 patients were identified from SLSR and 78 from ESPro; of these, 60% and 50% took OAC pre-stroke, respectively. Mean age was 75.9y in SLSR and 78.8y in Espro; 56.5% and 57.7% patients were females, respectively. Uptake of antiplatelets before stroke was lower in OAC-patients in both registers. However, these patients were more likely to use cholesterol-lowering medications. At 12months, no differences in recurrence rates were identified between OAC and noOAC-patients in both registers. In SLSR case-fatality rate was lower in OAC compared to noOAC-patients (42.9% versus 65.8%; p = 0.048); no significant differences were observed in ESPro.
Conclusions
The data suggests that OAC might be associated with improved patients’ outcomes, but sample size might be too small to identify significant differences. Clinical trials are warranted to confirm the impact of OAC use in ICH patients with comorbid AF. Analyses were partly funded by the EU within PRESTIGE-AF (No. 754517).
Patients with intracerebral haemorrhage (ICH) and atrial fibrillation (AF) have a high risk of recurrent ischemic stroke with a number of randomized controlled trials currently underway to identify optimal secondary preventive measures. Using two well-established population-based stroke registers, we describe characteristics and natural course of ICH patients with comorbid AF who are on oral anticoagulation (OAC) and no oral anticoagulation (noOAC) prior-to-stroke.
Methods
Data from the South London Stroke Register (SLSR) and the Erlangen Stroke Project (ESPro) from 1998 to 2020 were analysed. ICH patients with comorbid AF were grouped by pre-stroke use of OAC. Kaplan-Meier estimates of case-fatality and recurrence rates were applied.
Results
85 patients were identified from SLSR and 78 from ESPro; of these, 60% and 50% took OAC pre-stroke, respectively. Mean age was 75.9y in SLSR and 78.8y in Espro; 56.5% and 57.7% patients were females, respectively. Uptake of antiplatelets before stroke was lower in OAC-patients in both registers. However, these patients were more likely to use cholesterol-lowering medications. At 12months, no differences in recurrence rates were identified between OAC and noOAC-patients in both registers. In SLSR case-fatality rate was lower in OAC compared to noOAC-patients (42.9% versus 65.8%; p = 0.048); no significant differences were observed in ESPro.
Conclusions
The data suggests that OAC might be associated with improved patients’ outcomes, but sample size might be too small to identify significant differences. Clinical trials are warranted to confirm the impact of OAC use in ICH patients with comorbid AF. Analyses were partly funded by the EU within PRESTIGE-AF (No. 754517).
Original language | English |
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Article number | EPP0245/#1511 |
Pages (from-to) | 260-260 |
Number of pages | 1 |
Journal | European Stroke Journal |
Volume | 6 |
Issue number | Issue 1_suppl |
DOIs | |
Publication status | Published - 1 Sept 2021 |