19 Antithrombotic use and mortality outcomes in ischaemic stroke patients with atrial fibrillation: a Scottish database study. (22nd March 2023)

• Record Type: Journal Article
• Authors: Sterling, Kadie-Ann; Macleod, Mary Joan; Turner, Melanie
• Other Names: collab.
• Is Part Of: Heart. Volume 109(2023)Supplement 2
• Page Start: A7
• Page End: A7
• Publication Date: 2023-03-22
• Subjects: Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-SCF-2023.19
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Background: Current AF guidelines recommend using oral anticoagulants (OAC) in all eligible patients after an ischaemic stroke. This study examined the prescribing of antithrombotics in stroke patients with AF and its impact on one-year all-cause mortality. Methods: This is a population-based study using data from the Scottish Stroke Care Audit, Prescribing Information System, Scottish Morbidity Record 01, and the National Records of Scotland. This study included first-ever ischaemic stroke patients with AF between July 1, 2010, and June 30, 2015, who survived up to six months. Logistic regression and cox proportional hazards models were developed to describe variable associations. Results: There were 4547 patients with a mean age of 78.2 (±9.8) years and 51.4% were women. Overall, 2927 (64.4%) patients were prescribed an OAC, 2190 (48.2%) patients an antiplatelet, and 245 (5.3%) patients neither, within the first six months after stroke. Patients who were independent in activities of daily living and those living in less deprived areas had greater odds of receiving a prescription for an OAC. In comparison, the oldest patients (>85 years) and those living in more deprived areas had greater odds of receiving antiplatelet therapy. The prescribing of OAC (adjusted hazard ratio (HR) 0.28; 95% Confidence Interval (CI) 0.20 – 0.42) and antiplatelets (0.63; 0.46 – 0.86) were associated with lower odds of one-year all-cause mortality compared with no antithrombotic therapy. Conclusions: This study highlights the prescribing patterns and benefits of antithrombotics in secondary prevention. Both OAC and antiplatelets were associated with better survival within one year after stroke.