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Rates and Anticoagulation Treatment of Known Atrial Fibrillation in Patients with Acute Ischemic Stroke: A Real-World Study

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Abstract

Introduction

Known atrial fibrillation (AF) rate and appropriate prescription of oral anticoagulants (OACs) in acute ischemic stroke (AIS) patients with AF in China are not as well known as in Western countries.

Methods

Known AF and unknown AF, rate and adequacy of OACs use of AIS patients with AF attending five hospitals from April 2018 to August 2019 in the northwest region of China were investigated.

Results

A total of 344 patients were enrolled. Of these, 237 (AF-known group; 237/344, 68.9%) and 107 patients (AF-unknown group; 107/344, 31.1%) were diagnosed with AF before and after AIS during this hospitalization, respectively. In the AF-known group with echocardiography results (178 patients, including 103 female and 75 male patients), 154 of overall, 88 of female and 66 of male patients, respectively, were indicated to be taking OACs. However, the actual OACs proportion was much lower [overall (30.5%, 47/154); female (31.8%, 28/88) and male (28.8%, 19/66) patients] than indicated. Only one female patient met the guideline-based criteria for OACs. As for patients diagnosed with massive cerebral infraction (MCI; 43.0%, 148/344), the known AF rate was 65.5% (97/148). Among the MCI patients in the AF-known group with echocardiography results (61 patients), 50 patients had an OACs indication. However, only 22.0% (11/50) of these patients took OACs, and none met the guideline-based criteria for OACs.

Conclusions

This study revealed a low known AF rate, low OACs use rate and low rate of meeting the guideline-based criteria for OACs in AIS patients with AF in the northwest region of China. These findings indicated the importance of AF as a public health problem in China.

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Acknowledgements

We thank the participants of the study.

Funding

Clinical Research Program of the First Affiliated Hospital of Xi’an Jiaotong University of China (XJTU1AF-CRF-2018-015; no. XJTU1AF-CRF-2016-013). The journal’s Rapid Service Fee was funded by the authors.

Authorship

All authors contributed to drafting the manuscript, reviewing the manuscript content critically, and designing and implementation of the research. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole and have given their approval for this version to be published.

Medical Writing and Editorial Assistance

All authors acknowledge Chaofeng Sun for assistance in the editing of the manuscript. Editorial assistance was not funded.

Disclosures

Huijie Yuan, Jiaqi An, Qiang Zhang, Xiao Zhang, Man Sun, Tong Fan, Yawen Cheng, Meng Wei, Gary Tse, Xavier Waintraub, Yongxin Li, John D. Day, Fan Gao, Guogang Luo and Guoliang Li have nothing to disclose.

Compliance With Ethics Guidelines

This study analysis was conducted according to the 1964 Declaration of Helsinki, and consent was given to use clinical data. It was approved by the Ethics Committee of the First Affiliated Hospital of Xi’an Jiaotong University (no. XJTU1AF2018LSK-153). All participants of the study provided written informed consent to participate in the study.

Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Author information

Authors and Affiliations

  1. Stroke Centre and Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China

    Huijie Yuan, Jiaqi An, Yawen Cheng, Meng Wei & Guogang Luo

  2. Atrial Fibrillation Centre and Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China

    Huijie Yuan, Jiaqi An & Guoliang Li

  3. Department of Neurology, Shaanxi Provincial People’s Hospital, Xi’an, China

    Qiang Zhang

  4. Department of Neurology, Xijing Hospital of Air Force Military Medical University, Xi’an, China

    Xiao Zhang

  5. Department of Neurology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China

    Man Sun

  6. Department of Neurology, Xi’an Gaoxin Hospital, Xi’an, China

    Tong Fan

  7. Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, China

    Gary Tse

  8. Rhythmology Unit, Cardiology Institute, Hôpital Universitaire La Pitié-Salpêtrière, Paris, France

    Xavier Waintraub

  9. Department of Cardiovascular Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China

    Yongxin Li

  10. Intermountain Medical Center Heart Institute, Murray, UT, United States

    John D. Day

  11. Clinical Research Center, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China

    Fan Gao

Authors
  1. Huijie Yuan
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  2. Jiaqi An
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  3. Qiang Zhang
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  4. Xiao Zhang
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  5. Man Sun
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  6. Tong Fan
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  7. Yawen Cheng
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  8. Meng Wei
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  9. Gary Tse
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  10. Xavier Waintraub
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  11. Yongxin Li
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  12. John D. Day
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  13. Fan Gao
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  14. Guogang Luo
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  15. Guoliang Li
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Corresponding authors

Correspondence to Guogang Luo or Guoliang Li.

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Yuan, H., An, J., Zhang, Q. et al. Rates and Anticoagulation Treatment of Known Atrial Fibrillation in Patients with Acute Ischemic Stroke: A Real-World Study. Adv Ther 37, 4370–4380 (2020). https://doi.org/10.1007/s12325-020-01469-w

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  • DOI: https://doi.org/10.1007/s12325-020-01469-w

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