open access

Vol 48, No 2 (2014)
Review article
Submitted: 2014-03-05
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Presentation, therapy and outcome of patients with ischemic stroke under new oral anticoagulants

Claudia Stöllberger, Josef Finsterer
DOI: 10.1016/j.pjnns.2014.03.001
·
Neurol Neurochir Pol 2014;48(2):136-140.

open access

Vol 48, No 2 (2014)
Review article
Submitted: 2014-03-05

Abstract

Background

Aim was to describe the clinical spectrum, therapy, and outcome of ischemic strokes under therapy with new oral anticoagulants (NOAC).

Methods and results

A literature research was carried out in PubMed. Clinical trials as well as case reports were included. Four large trials comparing NOAC with warfarin reported 469 ischemic strokes but neither co-medication, nor comorbidities, location, clinical spectrum, therapy, nor outcome are reported. Eleven cases with ischemic strokes under dabigatran from the literature are reported. Six patients received thrombolytic therapy, in three of them unaware dabigatran therapy. Two patients received mechanical recanalization. Two patients died, one due to cerebral hemorrhage after thrombolysis, the other after partial recanalization of the basilar artery.

Conclusions

Little is known about ischemic strokes under NOAC. To increase the knowledge, the data of 469 ischemic strokes which occurred in NOAC-investigating trials should be analyzed. Furthermore ischemic and bleeding events under NOAC outside clinical trials should be reported. An international registry, independent from the pharmaceutical industry for collecting these informations is desirable.

Abstract

Background

Aim was to describe the clinical spectrum, therapy, and outcome of ischemic strokes under therapy with new oral anticoagulants (NOAC).

Methods and results

A literature research was carried out in PubMed. Clinical trials as well as case reports were included. Four large trials comparing NOAC with warfarin reported 469 ischemic strokes but neither co-medication, nor comorbidities, location, clinical spectrum, therapy, nor outcome are reported. Eleven cases with ischemic strokes under dabigatran from the literature are reported. Six patients received thrombolytic therapy, in three of them unaware dabigatran therapy. Two patients received mechanical recanalization. Two patients died, one due to cerebral hemorrhage after thrombolysis, the other after partial recanalization of the basilar artery.

Conclusions

Little is known about ischemic strokes under NOAC. To increase the knowledge, the data of 469 ischemic strokes which occurred in NOAC-investigating trials should be analyzed. Furthermore ischemic and bleeding events under NOAC outside clinical trials should be reported. An international registry, independent from the pharmaceutical industry for collecting these informations is desirable.

Get Citation

Keywords

Atrial fibrillation, Stroke, Dabigatran, Rivaroxaban, Thrombolysis

About this article
Title

Presentation, therapy and outcome of patients with ischemic stroke under new oral anticoagulants

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 48, No 2 (2014)

Pages

136-140

DOI

10.1016/j.pjnns.2014.03.001

Bibliographic record

Neurol Neurochir Pol 2014;48(2):136-140.

Keywords

Atrial fibrillation
Stroke
Dabigatran
Rivaroxaban
Thrombolysis

Authors

Claudia Stöllberger
Josef Finsterer

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