The Impact of Prior Antithrombotic Use on Blood Viscosity in Cardioembolic Stroke with Non-Valvular Atrial Fibrillation
Although clinical studies have demonstrated that prior use of antiplatelets was associated with decreased blood viscosity (BV) in patients with acute ischemic stroke, the impact of previous anticoagulant use on blood viscosity in cardioembolic stroke with non-valvular AF (NVAF) has not yet been clea...
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| Format: | Article |
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MDPI AG
2023-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/3/887 |
| _version_ | 1797624152345018368 |
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| author | Yo-Han Jung Sang-Won Han Joong-Hyun Park |
| author_facet | Yo-Han Jung Sang-Won Han Joong-Hyun Park |
| author_sort | Yo-Han Jung |
| collection | DOAJ |
| description | Although clinical studies have demonstrated that prior use of antiplatelets was associated with decreased blood viscosity (BV) in patients with acute ischemic stroke, the impact of previous anticoagulant use on blood viscosity in cardioembolic stroke with non-valvular AF (NVAF) has not yet been clearly studied. This single-center retrospective observational study aimed to determine the impact of prior antithrombotic (antiplatelet and anticoagulant) use on BV in patients with cardioembolic stroke (CES) due to NVAF. Patients with CES and NVAF were analyzed with the following inclusion criteria: (1) patients over 20 years of age admitted within five days of stroke onset; (2) ischemic stroke presumably due to an NVAF-derived embolus; (3) compatible cortical/subcortical lesion on brain computed tomography or magnetic resonance imaging; (4) hemoglobin level of 10–18 mg/dL; and (5) receiving antiplatelets within five days or anticoagulants within two days if previously medicated. From the screening of 195 patients (22% of the total stroke population during the study period) who had experienced ischemic stroke with AF, 160 were included for the final analysis. Eighty-nine patients (56%) were taking antithrombotics (antiplatelet, 57%; warfarin, 13%; NOACs, 30%) regularly. Compared to patients without previous antithrombotic use, those with previous antithrombotic use (antiplatelets, warfarin, and NOACs) were significantly associated with decreased systolic BV (SBV) and diastolic BV (DBV) (<i>p</i> < 0.036). In multiple linear regression analysis, hematocrit (Hct) level and prior antithrombotic use were significantly associated with decreased SBV and DBV. Hct was positively correlated with increased SBV and DBV. In Hct-adjusted partial correlation analysis, prior uses of any antithrombotic agents were associated with decreased SBV (r < −0.270, <i>p</i> < 0.015) and DBV (r < −0.183, <i>p</i> < 0.044). In conclusion, this study showed that prior antithrombotic use (antiplatelets, VKAs, and NOACs) was associated with decreased SBV and DBV in patients presenting with acute CES secondary to NVAF. Our results indicated that previous use of NOACs may be a useful hemorheological parameter in patients with acute CES due to NVAF. Accumulation of clinical data from a large number of patients with the risk of stroke occurrence, initial stroke severity, and functional outcome is necessary to assess the usefulness of BV. |
| first_indexed | 2024-03-11T09:39:03Z |
| format | Article |
| id | doaj.art-8814d8c061e84e93adf43abac049166b |
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| language | English |
| last_indexed | 2024-03-11T09:39:03Z |
| publishDate | 2023-01-01 |
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| spelling | doaj.art-8814d8c061e84e93adf43abac049166b2023-11-16T17:08:38ZengMDPI AGJournal of Clinical Medicine2077-03832023-01-0112388710.3390/jcm12030887The Impact of Prior Antithrombotic Use on Blood Viscosity in Cardioembolic Stroke with Non-Valvular Atrial FibrillationYo-Han Jung0Sang-Won Han1Joong-Hyun Park2Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of KoreaDepartment of Neurology, Inje University College of Medicine, Seoul 04551, Republic of KoreaDepartment of Neurology, Inje University College of Medicine, Seoul 04551, Republic of KoreaAlthough clinical studies have demonstrated that prior use of antiplatelets was associated with decreased blood viscosity (BV) in patients with acute ischemic stroke, the impact of previous anticoagulant use on blood viscosity in cardioembolic stroke with non-valvular AF (NVAF) has not yet been clearly studied. This single-center retrospective observational study aimed to determine the impact of prior antithrombotic (antiplatelet and anticoagulant) use on BV in patients with cardioembolic stroke (CES) due to NVAF. Patients with CES and NVAF were analyzed with the following inclusion criteria: (1) patients over 20 years of age admitted within five days of stroke onset; (2) ischemic stroke presumably due to an NVAF-derived embolus; (3) compatible cortical/subcortical lesion on brain computed tomography or magnetic resonance imaging; (4) hemoglobin level of 10–18 mg/dL; and (5) receiving antiplatelets within five days or anticoagulants within two days if previously medicated. From the screening of 195 patients (22% of the total stroke population during the study period) who had experienced ischemic stroke with AF, 160 were included for the final analysis. Eighty-nine patients (56%) were taking antithrombotics (antiplatelet, 57%; warfarin, 13%; NOACs, 30%) regularly. Compared to patients without previous antithrombotic use, those with previous antithrombotic use (antiplatelets, warfarin, and NOACs) were significantly associated with decreased systolic BV (SBV) and diastolic BV (DBV) (<i>p</i> < 0.036). In multiple linear regression analysis, hematocrit (Hct) level and prior antithrombotic use were significantly associated with decreased SBV and DBV. Hct was positively correlated with increased SBV and DBV. In Hct-adjusted partial correlation analysis, prior uses of any antithrombotic agents were associated with decreased SBV (r < −0.270, <i>p</i> < 0.015) and DBV (r < −0.183, <i>p</i> < 0.044). In conclusion, this study showed that prior antithrombotic use (antiplatelets, VKAs, and NOACs) was associated with decreased SBV and DBV in patients presenting with acute CES secondary to NVAF. Our results indicated that previous use of NOACs may be a useful hemorheological parameter in patients with acute CES due to NVAF. Accumulation of clinical data from a large number of patients with the risk of stroke occurrence, initial stroke severity, and functional outcome is necessary to assess the usefulness of BV.https://www.mdpi.com/2077-0383/12/3/887anticoagulantsatrial fibrillationstrokeviscosity |
| spellingShingle | Yo-Han Jung Sang-Won Han Joong-Hyun Park The Impact of Prior Antithrombotic Use on Blood Viscosity in Cardioembolic Stroke with Non-Valvular Atrial Fibrillation Journal of Clinical Medicine anticoagulants atrial fibrillation stroke viscosity |
| title | The Impact of Prior Antithrombotic Use on Blood Viscosity in Cardioembolic Stroke with Non-Valvular Atrial Fibrillation |
| title_full | The Impact of Prior Antithrombotic Use on Blood Viscosity in Cardioembolic Stroke with Non-Valvular Atrial Fibrillation |
| title_fullStr | The Impact of Prior Antithrombotic Use on Blood Viscosity in Cardioembolic Stroke with Non-Valvular Atrial Fibrillation |
| title_full_unstemmed | The Impact of Prior Antithrombotic Use on Blood Viscosity in Cardioembolic Stroke with Non-Valvular Atrial Fibrillation |
| title_short | The Impact of Prior Antithrombotic Use on Blood Viscosity in Cardioembolic Stroke with Non-Valvular Atrial Fibrillation |
| title_sort | impact of prior antithrombotic use on blood viscosity in cardioembolic stroke with non valvular atrial fibrillation |
| topic | anticoagulants atrial fibrillation stroke viscosity |
| url | https://www.mdpi.com/2077-0383/12/3/887 |
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