Research Article
Year 2025,
Volume: 52 Issue: 2, 357 - 367, 20.06.2025
Abstract
References
- 1.Hayashi T, Kato Y, Fukuoka T, et al. ClinicalFeatures of Ischemic Stroke during Treatment withDabigatran: An Association between DecreasedSeverity and a Favorable Prognosis. Intern Med.2015; 54: 2433-7.
- 2.Kim BJ, Kim HJ, Do Y, et al. The impact of priorantithrombotic status on cerebral infarction inpatients with atrial fibrillation. J Stroke CerebrovascDis. 2014; 23: 2054-59.
- 3.Eşkut N, Tarı M, Yarcı B, et al. Ischemiccerebrovasculer disease in patients using Non-vitamine K oral anticoagülan treatment. MedicalJournal of Izmir Hospital Turkey. 2023; 27: 14-20.
- 4.Almutairi AR, Zhou L, Gellad WF, et al.Effectiveness and Safety of Non-Vitamin KAntagonist Oral Anticoagulants for Atrial Fibrillation and Venous Thromboembolism: A Systematic Review and Meta-Analyses. ClinTher. 2017; 39: 1456–78.
- 5.Sepehri Shamloo A, Dagres N, Hindricks G. 2020ESC guidelines on atrialfibrillation: Summary of themost relevant recommendations and innovations.Herz. 2021; 46: 28-37.
- 6.Paciaroni M, Agnelli G, Caso V, et al. Prediction ofEarly Recurrent Thromboembolic Event and MajorBleeding in Patients with Acute Stroke and AtrialFibrillation by a Risk Stratification Schema: TheALESSA Score Study. Stroke. 2017; 48: 726-32.
- 7.Hindricks G, Potpara T, Dagres N, et al. 2020 ESCGuidelines for the diagnosis and management ofatrial fibrillation developed in collaboration with theEuropean Association for Cardio-Thoracic Surgery(EACTS): The Task Force fort he diagnosis andmanagement of atrial fibrillation of the EuropeanSociety of Cardiology (ESC) Developed with thespecial contribution of the European Heart RhythmAssociation (EHRA) of the ESC. Eur Heart J. 2021; 42:373-498.
- 8.Kwah LK, Diong J. National Institutes of HealthStroke Scale (NIHSS). J Physiother. 2014; 60: 61.
- 9.Camm AJ, Kirchhof P, Lip GY, et al. Guidelines forthe management of atrial fibrillation: the Task Forcefor the Management of Atrial Fibrillation of theEuropean Society of Cardiology (ESC). Eur Heart J2010; 31: 2369-429.
- 10.Asdaghi N, Jeerakathil T, Hameed B, et al.Oxfordshire community stroke project classificationpoorly differentiates small cortical and subcorticalinfarcts. Stroke 2011; 42: 2143-8.
- 11.Maura G, Billionnet C, Drouin J, et al. Oralanticoagulation therapy use in patients with atrialfibrillation after the introduction of non-vitamin Kantagonist oral anticoagulants: findings from theFrench health care databases, 2011-2016. BMJOpen. 2019; 9: e026645.
- 12.Albertsen IE, Rasmussen LH, Overvad TF, et al.Risk of stroke or systemic embolism in atrialfibrillation patients treated with warfarin: asystematic review and meta- analysis. Stroke. 2013;44: 1329-36.
- 13.Connolly SJ, Ezekowitz MD, Yusuf S, et al.Dabigatran versus warfarin in patients with atrialfibrillation. N Engl J Med. 2009; 361: 1139-51.
- 14.Diker S, Tanburoğlu A. Relationship of AtrialFibrillation with Recurrent Ischemic Stroke/Transient Ischemic Attack. Dicle Med J. 2022; 49:187-92.
- 15.Gallagher AM, Setakis E, Plumb JM, et al. Risks ofstroke and mortality associated with suboptimalanticoagulation in atrial fibrillation patients.Thromb Haemost. 2011; 106: 968-77.
- 16.Arihiro S, Todo K, Koga M, et al. Three-monthoutcomes in Japanese stroke/TIA patients with non-valvular atrial fibrillation after initiating oralanticoagulants: Thesamurai-NVAF study. Int JStroke. 2016; 11: 565–74.
- 17.Cappellari M, Bovi P. Continuation of direct oralanticoagulants in the acute phase of ischemic stroke.A caseseries. J Thromb Thrombolysis. Springer US;2017; 43: 248–51.
- 18.Calabrò P, Gragnano F, Cesaro A, et al. NOACs inpatients with atrial fibrillation and atrialthrombosis: An appraisal of current evidence. ArchCardiovasc Dis. 2020; 113: 642-51.
- 19.Ülkü S, Altay S, Gedikli Ö, et al. Real-World Dataon the Incidence of Stroke, Myocardial Infarction,and Mortality Among Nonvalvular Atrial FibrillationPatients in Turkiye: New Oral Anticoagulants-TURKey Study. Anatol J Cardiol. 2024; 28: 19-28.
- 20.Olivera P, Gavin O, Rivero E, et al. Acute IschemicEvents in Patient Receiving Direct OralAnticoagulants for Atrial Fibrilation: Incidence,Outcome and Clinical Profile. Blood. 2016; 128:1442-4.
- 21.Kanai Y, Oguro H, Tahara N, et al. Analysis ofRecurrent Stroke Volume and Prognosis betweenWarfarin and Four Non–Vitamin K Antagonist OralAnticoagulants’ Administration for SecondaryPrevention of Stroke. J Stroke Cerebrovasc Dis.2018; 27: 338–45.
- 22.Özer N. Clinical studies conducted with new oralanticoagulants in atrial fibrillation: Which oralanticoagulant can be considered for which case inlight of the clinical studies? Turk Kardiol Dern Ars.2016; 44: 33-40.
- 23.Ruff CT, Giugliano RP, Braunwald E, et al.Comparison of the efficacy and safety of new oralanticoagulants with warfarin in patients with atrialfibrillation: a meta-analysis of randomised trials.Lancet. 2014; 383: 955–62.
- 24.January CT, Wann LS, Alpert JS, et al. 2014AHA/ACC/HRS guideline for the management ofpatients with atrial fibrillation: execu- tivesummary: a report of the American College of Cardi- ology/American Heart Association Task Force onprac- tice guidelines and the Heart Rhythm Society.Circulation. 2014; 130: 2071–104.
- 25.Kim JA, Kim JE, Song SH, et al. Influence of bloodlipids on global coagulation test results. Ann LabMed. 2015; 35: 15-21.
- 26.Kotronen A, Joutsi-Korhonen L, Sevastianova K,et al. Increased coagulation factor VIII, IX, XI and XIIactivities in non-alcoholic fatty liver disease. LiverInt. 2011; 31: 176-83.
- 27.Tangvarasittichai S, Pongthaisong S,Tangvarasittichai O. Tumor Necrosis Factor-A,Interleukin-6, C-Reactive Protein Levels and InsulinResistance Associated with Type 2 Diabetes inAbdominal Obesity Women. Indian J Clin Biochem.2016; 31: 68-74.
- 28.Boz P, Boz M, Acar D, et al. The Effect ofNeutrophil to Lymphocyte and Neutrophil toPlatelet Ratios on Prognosis in Stroke Patients. DicleTıp Dergisi. 2022; 49: 558-64.
- 29.Brouwers MC, Govers-Riemslag J, Schalkwijk CG,et al. Plasma PAI-1 levels are independently relatedto fatty liver and hypertriglyceridemia in familialcombined hyperlipidemia, involvement ofapolipoprotein E. Thromb Res. 2008; 122: 466-72.
- 30.Simpson HC, Mann JI, Meade TW, et al.Hypertriglyceridaemia and hypercoagulability.Lancet. 1983; 321: 786-90.
Year 2025,
Volume: 52 Issue: 2, 357 - 367, 20.06.2025
Abstract
Amaç: Non-valvüler atriyal fibrilasyon (NVAF) iskemik inmenin en yaygın nedenidir. NVAF’ye bağlı inmeden primer korunma tedavisinde varfarin kullanılırken, son zamanlarda yeni nesil oral antikoagülanlar (YOAK) ilk tercih olmaktadır. YOAK kullanan hastalarda her yıl %1-2 iskemik inme görülmesi nedeniyle riskli hastaların belirlenmesi önemlidir. Bu çalışmada, YOAK kullanırken inme gelişen hastaların klinik özelliklerinin ve riski artıran faktörlerin belirlenmesi amaçlandı.
Yöntemler: YOAK kullanırken inme geçiren hastalar ile kontrol grubunun demografik bilgileri, klinik özellikleri, laboratuvar ve radyolojik bulguları retrospektif olarak değerlendirildi.
Bulgular: NVAF ilişkili ilk defa inme geçiren 35 hasta dosyasına ulaşıldı. Bu hastaların 13’ü YOAK kullanırken inme geçirmişti, 8’i (%61.5) erkek, 5’i (%39.5) kadın idi. Ortalama yaş 75±11 yıldı. Hastaların başvuru NIHSS’si kontrol grubuna göre yüksekti. TEE’de 3 hastada (%23.1) sol atriyal trombüs tespit edilmişti. Hasta grubunda trigliserit, nötrofil lenfosit oranı (NLO), nötrofil platelet oranı (NPO) ve türetilmiş NLO (dNLO) düzeylerinin kontrol grubuna göre yüksek olduğu bulundu.
Sonuç: NVAF nedeniyle YOAK tedavisi alan hastalarda inme geliştiğinde, ilaç başarısızlığına sebep olabilecek sol atriyal trombüs ve konjestif kalp yetmezliği en çok bilinen risk faktörleridir. Bu çalışmada tespit edilen yüksek trigliserit, NLO ve NPO düzeyleri ise riskli hastaları belirlemede diğer önemli parametreler olup daha fazla hasta üzerinde prospektif olarak araştırılmalıdırlar.
References
- 1.Hayashi T, Kato Y, Fukuoka T, et al. ClinicalFeatures of Ischemic Stroke during Treatment withDabigatran: An Association between DecreasedSeverity and a Favorable Prognosis. Intern Med.2015; 54: 2433-7.
- 2.Kim BJ, Kim HJ, Do Y, et al. The impact of priorantithrombotic status on cerebral infarction inpatients with atrial fibrillation. J Stroke CerebrovascDis. 2014; 23: 2054-59.
- 3.Eşkut N, Tarı M, Yarcı B, et al. Ischemiccerebrovasculer disease in patients using Non-vitamine K oral anticoagülan treatment. MedicalJournal of Izmir Hospital Turkey. 2023; 27: 14-20.
- 4.Almutairi AR, Zhou L, Gellad WF, et al.Effectiveness and Safety of Non-Vitamin KAntagonist Oral Anticoagulants for Atrial Fibrillation and Venous Thromboembolism: A Systematic Review and Meta-Analyses. ClinTher. 2017; 39: 1456–78.
- 5.Sepehri Shamloo A, Dagres N, Hindricks G. 2020ESC guidelines on atrialfibrillation: Summary of themost relevant recommendations and innovations.Herz. 2021; 46: 28-37.
- 6.Paciaroni M, Agnelli G, Caso V, et al. Prediction ofEarly Recurrent Thromboembolic Event and MajorBleeding in Patients with Acute Stroke and AtrialFibrillation by a Risk Stratification Schema: TheALESSA Score Study. Stroke. 2017; 48: 726-32.
- 7.Hindricks G, Potpara T, Dagres N, et al. 2020 ESCGuidelines for the diagnosis and management ofatrial fibrillation developed in collaboration with theEuropean Association for Cardio-Thoracic Surgery(EACTS): The Task Force fort he diagnosis andmanagement of atrial fibrillation of the EuropeanSociety of Cardiology (ESC) Developed with thespecial contribution of the European Heart RhythmAssociation (EHRA) of the ESC. Eur Heart J. 2021; 42:373-498.
- 8.Kwah LK, Diong J. National Institutes of HealthStroke Scale (NIHSS). J Physiother. 2014; 60: 61.
- 9.Camm AJ, Kirchhof P, Lip GY, et al. Guidelines forthe management of atrial fibrillation: the Task Forcefor the Management of Atrial Fibrillation of theEuropean Society of Cardiology (ESC). Eur Heart J2010; 31: 2369-429.
- 10.Asdaghi N, Jeerakathil T, Hameed B, et al.Oxfordshire community stroke project classificationpoorly differentiates small cortical and subcorticalinfarcts. Stroke 2011; 42: 2143-8.
- 11.Maura G, Billionnet C, Drouin J, et al. Oralanticoagulation therapy use in patients with atrialfibrillation after the introduction of non-vitamin Kantagonist oral anticoagulants: findings from theFrench health care databases, 2011-2016. BMJOpen. 2019; 9: e026645.
- 12.Albertsen IE, Rasmussen LH, Overvad TF, et al.Risk of stroke or systemic embolism in atrialfibrillation patients treated with warfarin: asystematic review and meta- analysis. Stroke. 2013;44: 1329-36.
- 13.Connolly SJ, Ezekowitz MD, Yusuf S, et al.Dabigatran versus warfarin in patients with atrialfibrillation. N Engl J Med. 2009; 361: 1139-51.
- 14.Diker S, Tanburoğlu A. Relationship of AtrialFibrillation with Recurrent Ischemic Stroke/Transient Ischemic Attack. Dicle Med J. 2022; 49:187-92.
- 15.Gallagher AM, Setakis E, Plumb JM, et al. Risks ofstroke and mortality associated with suboptimalanticoagulation in atrial fibrillation patients.Thromb Haemost. 2011; 106: 968-77.
- 16.Arihiro S, Todo K, Koga M, et al. Three-monthoutcomes in Japanese stroke/TIA patients with non-valvular atrial fibrillation after initiating oralanticoagulants: Thesamurai-NVAF study. Int JStroke. 2016; 11: 565–74.
- 17.Cappellari M, Bovi P. Continuation of direct oralanticoagulants in the acute phase of ischemic stroke.A caseseries. J Thromb Thrombolysis. Springer US;2017; 43: 248–51.
- 18.Calabrò P, Gragnano F, Cesaro A, et al. NOACs inpatients with atrial fibrillation and atrialthrombosis: An appraisal of current evidence. ArchCardiovasc Dis. 2020; 113: 642-51.
- 19.Ülkü S, Altay S, Gedikli Ö, et al. Real-World Dataon the Incidence of Stroke, Myocardial Infarction,and Mortality Among Nonvalvular Atrial FibrillationPatients in Turkiye: New Oral Anticoagulants-TURKey Study. Anatol J Cardiol. 2024; 28: 19-28.
- 20.Olivera P, Gavin O, Rivero E, et al. Acute IschemicEvents in Patient Receiving Direct OralAnticoagulants for Atrial Fibrilation: Incidence,Outcome and Clinical Profile. Blood. 2016; 128:1442-4.
- 21.Kanai Y, Oguro H, Tahara N, et al. Analysis ofRecurrent Stroke Volume and Prognosis betweenWarfarin and Four Non–Vitamin K Antagonist OralAnticoagulants’ Administration for SecondaryPrevention of Stroke. J Stroke Cerebrovasc Dis.2018; 27: 338–45.
- 22.Özer N. Clinical studies conducted with new oralanticoagulants in atrial fibrillation: Which oralanticoagulant can be considered for which case inlight of the clinical studies? Turk Kardiol Dern Ars.2016; 44: 33-40.
- 23.Ruff CT, Giugliano RP, Braunwald E, et al.Comparison of the efficacy and safety of new oralanticoagulants with warfarin in patients with atrialfibrillation: a meta-analysis of randomised trials.Lancet. 2014; 383: 955–62.
- 24.January CT, Wann LS, Alpert JS, et al. 2014AHA/ACC/HRS guideline for the management ofpatients with atrial fibrillation: execu- tivesummary: a report of the American College of Cardi- ology/American Heart Association Task Force onprac- tice guidelines and the Heart Rhythm Society.Circulation. 2014; 130: 2071–104.
- 25.Kim JA, Kim JE, Song SH, et al. Influence of bloodlipids on global coagulation test results. Ann LabMed. 2015; 35: 15-21.
- 26.Kotronen A, Joutsi-Korhonen L, Sevastianova K,et al. Increased coagulation factor VIII, IX, XI and XIIactivities in non-alcoholic fatty liver disease. LiverInt. 2011; 31: 176-83.
- 27.Tangvarasittichai S, Pongthaisong S,Tangvarasittichai O. Tumor Necrosis Factor-A,Interleukin-6, C-Reactive Protein Levels and InsulinResistance Associated with Type 2 Diabetes inAbdominal Obesity Women. Indian J Clin Biochem.2016; 31: 68-74.
- 28.Boz P, Boz M, Acar D, et al. The Effect ofNeutrophil to Lymphocyte and Neutrophil toPlatelet Ratios on Prognosis in Stroke Patients. DicleTıp Dergisi. 2022; 49: 558-64.
- 29.Brouwers MC, Govers-Riemslag J, Schalkwijk CG,et al. Plasma PAI-1 levels are independently relatedto fatty liver and hypertriglyceridemia in familialcombined hyperlipidemia, involvement ofapolipoprotein E. Thromb Res. 2008; 122: 466-72.
- 30.Simpson HC, Mann JI, Meade TW, et al.Hypertriglyceridaemia and hypercoagulability.Lancet. 1983; 321: 786-90.
There are 30 citations in total.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Medical Education, Health Services and Systems (Other) |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | June 20, 2025 |
| Submission Date | January 15, 2025 |
| Acceptance Date | May 14, 2025 |
| Published in Issue | Year 2025 Volume: 52 Issue: 2 |
