학술논문

Oral Anticoagulation and Adverse Outcomes after Ischemic Stroke in Heart Failure Patients without Atrial Fibrillation
Document Type
article
Source
Journal of Cardiac Failure. 27(8)
Subject
Biomedical and Clinical Sciences
Clinical Sciences
Clinical Research
Brain Disorders
Aging
Heart Disease
Stroke
Cardiovascular
Aged
Anticoagulants
Atrial Fibrillation
Brain Ischemia
Heart Failure
Humans
Ischemic Stroke
Medicare
United States
Oral Anticoagulation
Mortality
Hemorrhage
Cardiorespiratory Medicine and Haematology
Nursing
Cardiovascular System & Hematology
Cardiovascular medicine and haematology
Clinical sciences
Language
Abstract
BackgroundThe safety and effectiveness of oral anticoagulation (OAC) after an ischemic stroke in older patients with heart failure (HF) without atrial fibrillation remains uncertain.MethodsUtilizing Get With The Guidelines Stroke national clinical registry data linked to Medicare claims from 2009-2014, we assessed the outcomes of eligible patients with a history of HF who were initiated on OAC during a hospitalization for an acute ischemic stroke. The cumulative incidences of adverse events were calculated using Kaplan-Meier curves and adjusted Cox proportional hazard ratios were compared between patients discharged on or off OAC.ResultsA total of 8,261 patients from 1,370 sites were discharged alive after an acute ischemic stroke and met eligibility criteria. Of those, 747 (9.0%) were initiated on OAC.  Patients on OAC were younger (77.2±8.0 vs. 80.5±8.9 years, p