25 Jun 2024 • Patients with atrial fibrillation (AF) are at high risk of recurrent ischemic stroke (IS) and mortality, even with secondary prevention using oral anticoagulants (OAC). Discontinuation of OAC doubles the risk of recurrent IS compared to patients who continue OAC. Therefore, it is crucial to maintain OAC therapy and improve secondary stroke prevention in AF patients.

• This nationwide cohort study in Denmark included 8,119 patients (54.1% male, mean age 78.4 years) patients aged 50 or older with AF and IS, who initiated or restarted OAC treatment. 663 patients experienced a recurrent ischemic stroke out of whom 533 (80.4%) were receiving oral anticoagulants at the time of recurrence.

• The crude cumulative incidence of recurrent IS at 1 year was 4.3% and for all-cause mortality, it was 15.4%. Patients who discontinued OACs had a significantly higher risk of recurrent IS (13.4% discontinuation vs. 6.8% continuation; adjusted odds ratio 2.13) compared to those who continued OAC therapy.

Source:JAMA| Read full story