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Tavlueva E.V

National Medical Research Center for therapy and Preventive Medicine, Russian Federation

Title: Frequency of use of oral anticoagulants in real clinical practice in patients hospitalized with acute ischemic stroke

Abstract

Target: To evaluate the frequency of prescribing oral anticoagulants in patients hospitalized with Stroke. 
Material and methods: 114 patients with atrial fibrillation (AF) and stroke were included in open observational prospective study. The observation was carried out during the period of hospitalization and averaged 10 (8; 16;) days. 
Results: It was found that more than half of the patients - 63 (55.3%) did not take either antiplatelet agents or anticoagulants, 9 (7.9%) patients took aspirin or clopidogrel. In 12 (10.5%) patients, it was not possible to find out the features of taking medications at the outpatient stage due to the severity of the condition or the presence of aphasia. Only 30 (26.3%) patients were taking anticoagulants (21 - oral anticoagulants (NOAC), 9 - warfarin). At the same time, among those taking warfarin, only one patient had an international normalized ratio (INR) within the normative values ??at the time of hospitalization (INR = 2.6). 105 patients were discharged, 93 (88.6%) patients were prescribed anticoagulants. 89 (84.8%) patients were prescribed NOAC and four (3.8%) patients - warfarin. 12 patients have not recommended oral anticoagulants after  discharge: four (33.3%) patients were diagnosed with peptic ulcer in the acute stage during hospitalization, 2 (16.7%) – were diagnosed hemorrhagic, 6 (50%)  patients were recommended aspirin. 
Conclusion: Our study demonstrated that in most cases, patients with a permanent form of AF who are admitted to the hospital with ischemic stroke, definitely receive anticoagulant therapy in an insufficient percentage of cases. At the same time, 90% patients were taking anticoagulants at the time of discharge from the hospital.

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