Intensity of anticoagulation and clinical outcomes in acute cardioembolic stroke the Fukuoka stroke Registry

Asako Nakamura, Tetsuro Ago, Masahiro Kamouchi, Jun Hata, Ryu Matsuo, Junya Kuroda, Takahiro Kuwashiro, Hiroshi Sugimori, Takanari Kitazono

研究成果: ジャーナルへの寄稿学術誌査読

31 被引用数 (Scopus)


Background and Purpose: The relationship between the intensity of anticoagulation at the onset of acute cardioembolic stroke and clinical outcome after stroke is unclear. Here, we elucidated the relationship between prothrombin time-international normalized ratio (PT-INR) values on admission and clinical outcomes in patients with acute cardioembolic stroke. Methods: A total of 602 patients from the Fukuoka Stroke Registry in Japan who had been treated with warfarin but developed cardioembolic stroke were enrolled. The patients were classified into 3 groups according to their PT-INR values on admission: PT-INR <1.50, 411 patients; PT-INR 1.50 to 1.99, 146 patients; and PT-INR ≥2.00, 45 patients. The associations between PT-INR categories and severe neurological deficits (National Institutes of Health Stroke Scale ≥10) on admission and poor functional outcome (modified Rankin scale 4-6) at discharge were investigated using a logistic regression analysis. Results: Neurological deficits on admission were less severe, and functional outcome at discharge was more favorable as the PT-INR level on admission increased. The multivariate analysis revealed that severe neurological deficits were inversely associated with PT-INR on admission (PT-INR 1.50-1.99: odds ratio, 0.66;95% confidence interval, 0.43-1.00; PT-INR ≥2.00: odds ratio, 0.41;95% confidence interval, 0.20-0.83; compared with a reference group of PT-INR <1.50). Poor functional outcome was less likely in patients with PT-INR ≥2.00 (odds ratio, 0.20;95% confidence interval, 0.06-0.55) after adjustment for confounders. Conclusions: Prestroke PT-INR ≥2.0 is associated with favorable clinical outcomes after acute cardioembolic stroke.

出版ステータス出版済み - 11月 2013

!!!All Science Journal Classification (ASJC) codes

  • 臨床神経学
  • 循環器および心血管医学
  • 高度および特殊看護


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