A retrospective study on patients with stroke and non-rheumatic atrial fibrillation treated with anticoagulation / 中国综合临床

ABSTRACT

Objective To investigate the current statues of anticoagulation therapy for ischemic stroke patients with atrial fibrillation(AF) and compared the difference with guidelines.Methods Three hundred and fifty-eight patients with cerebral infarction and atrial fibrillation in Xinhua Hospital Affiliated to Shanghai Jiaotong University from Jan.2008 to Jun.2012 were selected as our subjects.The data related to the antithrombotic therapy were collected and analyzed.Results Among patients with ischemic stroke,the rate of preexisting AF was 70.9％ (254/358),and warfarin taken rate was 4.3％ (11/254) before stroke onset.Of warfarin taken patients,INR were less than 1.5.Of all out hospitalized patients,20.9％ (68/326) were treated with warfarin therapy.There were the negative correlation between warfarin usage and HAS-BLED score,MRS score,antiplatelet drugs (OR =-1.974,-0.725,-4.170,P ＜ 0.05 or P ＜ 0.01).Among patients with warfarin usage in hospital,33.8％ of subjects (23/68) still remain on warfarin even out of hospital.The medium dosage was 2.5 mg (1.25-3.75 mg),and INR was controlled at ranged of 1.5-3.1.Periods of warfarin therapeutic range (TTR) was (61.6 ± 21.2)％.Conclusion The anticoagulation treatment rate and INR were lower in patients cerebral infarction with atrial fibrillation.Warfar might no be universal use due to the bleeding concerns and un-onvenience of monitoring INR.