Abstract | BACKGROUND AND OBJECTIVE: DESIGN: Retrospective study based on prospectively collected data in SITS (Safe Implementation of Treatment in Stroke) Thrombolysis and Thrombectomy Registry from July 2014 to July 2018. PARTICIPANTS: European NVAF patients (≥18 years) hospitalised after first-ever ischaemic stroke. SETTING: A multinational, observational monitoring register. INTERVENTION: PRIMARY AND SECONDARY OUTCOMES: The primary outcome was time from first-ever ischaemic stroke (index event) to dabigatran initiation. Additional outcomes included physicians' reasons for delaying dabigatran initiation beyond acute hospital discharge and outcomes within 3 months of index event. METHODS: We identified patients with NVAF who received dabigatran within 3 months of the index event. We performed descriptive statistics for baseline and demographic data and clinical outcomes after dabigatran initiation. RESULTS: In total, 1489 patients with NVAF received dabigatran after AIS treated with thrombolysis and/or thrombectomy. Of these, 1240 had available initiation time. At baseline, median age was 75 years; 53% of patients were women, 15% were receiving an oral anticoagulant, 29% acetylsalicylic acid and 4% clopidogrel. Most patients (82%) initiated dabigatran within 14 days after the index event. Patients initiating earlier had lower stroke severity from median NIHSS 8 (IQR 6-13) if initiated within 7 days to NIHSS 15 (9-19) if initiated between 28 days and 3 months. Most common reasons for delaying initiation were haemorrhagic transformation or intracranial haemorrhage, stroke severity and infarct size. Few thrombotic/haemorrhagic events occurred within 3 months after the index event (20 of 926 patients, 2.2% with the available data). CONCLUSIONS: Our findings, together with previous observational studies, indicate that dabigatran initiated within the first days after an AIS is safe in patients treated with intravenous thrombolysis, endovascular thrombectomy or both. TRIAL REGISTRATION NUMBER:
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Authors | Irene Escudero-Martinez, Michael Mazya, Christine Teutsch, Norbert Lesko, Zuzana Gdovinova, Leonardo Barbarini, Waldemar Fryze, Michal Karlinski, Adam Kobayashi, Georgi Krastev, Ana Paiva Nunes, Katarina Pasztoova, André Peeters, Piotr Sobolewski, Aleksandras Vilionskis, Danilo Toni, Niaz Ahmed, SITS Investigators |
Journal | BMJ open
(BMJ Open)
Vol. 10
Issue 5
Pg. e037234
(05 19 2020)
ISSN: 2044-6055 [Electronic] England |
PMID | 32434935
(Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
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Copyright | © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. |
Chemical References |
- Anticoagulants
- Dabigatran
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Topics |
- Aged
- Anticoagulants
(therapeutic use)
- Atrial Fibrillation
- Brain Ischemia
(drug therapy)
- Dabigatran
(therapeutic use)
- Female
- Humans
- Ischemic Stroke
- Male
- Registries
- Retrospective Studies
- Stroke
(drug therapy)
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