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Effects of dabigatran and rivaroxaban on stroke severity according to the results of routine coagulation tests
- Source :
- PLoS ONE, Vol 15, Iss 10, p e0240483 (2020), PLoS ONE
- Publication Year :
- 2020
- Publisher :
- Public Library of Science (PLoS), 2020.
-
Abstract
- IntroductionPrior use of direct oral anticoagulants has been associated with reduced stroke severity in patients with non-valvular atrial fibrillation (NVAF). The aim of this study was to investigate the impact of prothrombin time (PT) and activated partial thromboplastin time (aPTT) on stroke severity in patients who were receiving dabigatran or rivaroxaban at the time of stroke onset.Materials and methodsWe enrolled 107 patients with NVAF who developed acute ischemic stroke while on dabigatran or rivaroxaban and presented within 24 hours to nine hospitals between January 2014 and December 2018. The results of PT and aPTT assays were obtained within 24 hours of stroke onset in all patients. We analyzed PT and aPTT in relation to stroke severity and ischemic lesion volume using correlation and multivariable regression analyses.ResultsOf the 107 patients included, 46 (43.0%) were on dabigatran and 61 (57.0%) were on rivaroxaban. In patients with prior dabigatran use, while aPTT was inversely correlated with admission National Institutes of Health Stroke Scale (NIHSS) score (r = -0.369, p = 0.012) and ischemic lesion volume (r = -0.480, p = 0.005), there was no correlation between PT and either of these variables. Multivariable analysis confirmed the existence of a significant independent inverse relationship between aPTT and NIHSS score at admission (B, -0.201; 95% confidence interval [CI], -0.370 to -0.032; p = 0.005) and between aPTT and ischemic lesion volume (B, -0.076; 95% CI, -0.130 to -0.023; p = 0.007). In patients with prior rivaroxaban use, neither PT nor aPTT was associated with admission NIHSS score or ischemic lesion volume in the correlation and multivariable analyses.ConclusionsIn patients with NVAF who were receiving dabigatran, prolonged aPTT was associated with reduced stroke severity.
- Subjects :
- Male
Physiology
Stroke severity
Antiplatelet Therapy
Severity of Illness Index
Vascular Medicine
Biochemistry
Brain Ischemia
Diagnostic Radiology
Medical Conditions
Mathematical and Statistical Techniques
Rivaroxaban
Atrial Fibrillation
Coagulation testing
Medicine and Health Sciences
Aged, 80 and over
Brain Mapping
Multidisciplinary
medicine.diagnostic_test
Pharmaceutics
Radiology and Imaging
Statistics
Atrial fibrillation
Proteases
Middle Aged
Prognosis
Magnetic Resonance Imaging
Dabigatran
Enzymes
Body Fluids
Stroke
Blood
Neurology
Acute Disease
Physical Sciences
Cardiology
Regression Analysis
Medicine
Female
Partial Thromboplastin Time
Anatomy
medicine.drug
Partial thromboplastin time
Research Article
circulatory and respiratory physiology
medicine.medical_specialty
Imaging Techniques
Cerebrovascular Diseases
Brain Morphometry
Science
Neuroimaging
Linear Regression Analysis
Research and Analysis Methods
Antithrombins
Blood Plasma
Signs and Symptoms
Drug Therapy
Diagnostic Medicine
Internal medicine
medicine
Humans
cardiovascular diseases
Statistical Methods
Aged
Retrospective Studies
Ischemic Stroke
Prothrombin time
business.industry
Diffusion Weighted Imaging
Biology and Life Sciences
Proteins
medicine.disease
Confidence interval
Prothrombin Time
Lesions
Enzymology
Clinical Medicine
Serine Proteases
business
Mathematics
Factor Xa Inhibitors
Follow-Up Studies
Neuroscience
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 15
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.doi.dedup.....67ceb591b4e8f1644352d11de5043b86