Direct Oral Anticoagulants in Patients Undergoing Urgent Reperfusion for Nonvalvular Atrial Fibrillation-Related Ischemic Stroke: A Brief Report on Literature Evidence

Table 1

Summary of selected studies.

Author Reference (year)

Study; design

Pts; (N)

Females; (%)

Age; (years, median, IQR or mean ± SD)

Antithrombotic therapy; before stroke; N (%)

NIHSS at hospital admission (median, IQR)

Large infarct size; N (%)

Reperfusion type

DOACs starting; (days, median, IQR)

DOAC type

Low dose; N (%)

CHA2DS2-VASC; Score after index event; (median, IQR)

HAS-BLED; Score after index event; (median, IQR)

Follow-up

Stroke recurrence and/or intracranial bleeding at follow-up

All cause mortality at follow-up

Masotti (2018) [6]

Retrospective

35

23 (65.7%)

84; (78-88)

AP 11 (31.4%; VKAs 6 (17.1%); DOACs 0

12 (6-17)

18 (58.2%)

rtPA 28; Mechanical thrombectomy 3; rtPA plus mechanical thrombectomy 4

6 (4-8)

Dab 9; Riv 3; Api 17; Edo 6

21 (60%)

5 (4-6)

3 (3-3.5)

90-day

1 (2.8%)

0

Saji (2016) [7]

Prospective observational

37

21 (56.7%)

76.8 ± 10.2

AP 6 (16.2%); VKAs 10 (27.4%); DOACs 3 (8.1%)

13 (8-19)

14 (37.8%)

rtPA 37

2 (2-3)

Dab 10; Riv 22; Api 5

NA

4 (2-5)

NA

30-day

1 (2.7%

0

Ritzenthaler; (2015) [8]

Retrospective

34

18 (51.4%)

81; (71-85)

NA

9 (6-13)

NA

rtPA 34

6 (4-11)

Dab 9; Riv 25

0 (0%)

6 (4-6)

≥3; 26 (76.5%)

14-day

0

0

anterior lesions involved the complete territory of the middle cerebral artery (MCA), posterior cerebral artery, or anterior cerebral artery or were in 2 cortical superficial branches of the MCA, in a cortical superficial branch of MCA associated with the MCA deep branch, or in >1 artery territory (e.g., MCA associated with anterior cerebral artery territory); lesions ≥1.5 cm in the brain stem or cerebellum.
infarct size ≥ 3 cm.
N, number; IQR, interquartile range; SD, standard deviation; NIHSS, National Istitute of HealtStroke Scale; DOAC, direct oral anticoagulants; mRS, Modified Rankin Scale; TIA, transient ischemic attack; HT, hemorrhagic transformation; NA, not available; DWI, diffusion-weighted images; AP, antiplatelets; VKAs, vitamin K antagonists; AC, nonspecified anticoagulants; dab, dabigatran; riv, rivaroxaban; api, apixaban; edo, edoxaban; rtPA, recombinant tissue plasminogen activator.