Abstract | PURPOSE: Patients with stroke are at high risk of recurrence of vascular events. Non- vitamin K oral anticoagulant ( NOAC) and vitamin K antagonists (VKA) are used as secondary prophylaxis. The aim of this study was to evaluate the utilization of NOAC and VKA, and their impact on re- stroke or death in Austria. METHODS: We analyzed retrospective data between 2012 and 2017 from medical services covered by the health insurance funds, which provides health care for all residents in Austria. Patients without anticoagulant medication 3 months preceding the index event were eligible. RESULTS: 76 354 patients were discharged with a hospital diagnosis of stroke. From these, 16 436 patients with a median age of 78 years received VKA or NOAC. After adjustment, the recurrence of stroke was less frequent in patients with NOAC compared to those with VKA (HR 0.87; 95%CI 0.77-0.97). However, there was no difference in mortality rate after adjustment for age, sex, and co-morbidities for patients with NOAC (HR 1.0; 95%CI 0.92-1.08). Diabetes (HR 1.25, 95%CI 1.08-1.45; HR 1.25, 95% CI 1.13-1.38) and cardiovascular disease (HR 1.43, 95%CI 1.24-1.65; HR 1.27, 95%CI 1.16-1.39) were significantly associated with re- stroke or death. Younger age (p = 0.0028; HR 0.99, 95%CI 0.99-0.99) was significantly associated with re- stroke, and advanced age (p < 0.0001; HR 1.09, 95%CI 1.08-1.09) with death. CONCLUSION:
NOAC prescription is related with a reduced risk of re- stroke but increased mortality compared to patients with VKA. The event risk is associated with diabetes, cardiovascular disease and age.
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Authors | Jasmina Preinreich, Safoura Sheikh Rezaei, Martina Mittlböck, Stefan Greisenegger, Berthold Reichardt, Michael Wolzt |
Journal | Pharmacoepidemiology and drug safety
(Pharmacoepidemiol Drug Saf)
Vol. 30
Issue 10
Pg. 1332-1338
(10 2021)
ISSN: 1099-1557 [Electronic] England |
PMID | 34021676
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © 2021 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd. |
Chemical References |
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Topics |
- Aged
- Anticoagulants
- Austria
- Cohort Studies
- Humans
- Retrospective Studies
- Stroke
(epidemiology, prevention & control)
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