Introduction:

Cardioembolic stroke recurrence rate could be up to 10% in the first year and increases over time. There is a lack of evidence concerning the best therapeutic approach in patients with recurrent stroke while on anticoagulation.

Objective:

To explore the relationship between anticoagulant type and the composite outcome of ischemic stroke, transient ischemic attack (TIA) or systemic embolism in patients with recurrent atrial fibrillation related stroke with anticoagulation.

Materials and method:

Cross-sectional study involving patients who attended the stroke unit between 2014- 2019 for atrial fibrillation related stroke. Patients with clinical records after index stroke were considered. Patients were divided into recurrent/non-recurrent and were compared in terms of sociodemographic factors, comorbidities and oral anticoagulant used. Meanwhile. the recurrent group were characterized in severity, dosification and plasma anticoagulation levels.

Results:

60 patients were included (17 with recurrence and 43 without recurrence); regarding the patients who had a recurrence, 82.3% of the events were stroke, 17.6% were TIA, and no systemic embolism events with a recurrence median time of 398 days. It was not found any relationship between the type of anticoagulation and the pre-specified outcomes, although a considerable prevalence of underdosing and subtherapeutic blood anticoagulant levels was found.

Conclusion:

It is not possible to conclude on any relationship between the type of anticoagulant and the occurrence of a recurrent event. However, the study of these factors and their role on the occurrence of the event is beyond the aim and scope of the present study and should be elucidated in future studies.

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