Effect of anticoagulation on infarct volume and NIHSS score in patients with atrial fibrillation and ischaemic stroke Atriyal fibrilasyon ve iskemik inme hastalarında antikoagülasyonun infarkt hacmi ve NIHSS skoru üzerine etkisi

Purpose: The aim of this study was to evaluate the use of oral anticoagulation (OAC) in patients with cardioembolic stroke due to non-valvular atrial fibrillation (NVAF). The NIHSS (National Institute of Healt Stroke Scale) score calculated by a neurologist at initial presentation and infarct volume measured semi-automatically in cm3 by Magnetic Resonance Imaging (MRI). Materials and methods: A total of 101 NVAF patients with acute ischaemic stroke were included in this retrospective study. Patients were divided into 4 groups according to OAC drug use: Non-OAC users (Group 1), subtherapeutic dose warfarin users (under 70 years of age: INR≤2.0; over 70 years of age: INR≤1.6 Group 2), therapeutic dose warfarin users (under 70 years of age: INR≥2.0; over 70 years of age: INR≥1.6 Group 3) and therapeutic dose Non-vitamin K oral anticoagulant (NOAC) users Group 4. Results: Infarct volume was calculated as 22.20 cm3 median (0.4-235 cm3 lowest-highest) for Group 1; 12.95 cm3 (1.3-129 cm3) for Group 2; 2.25 cm3 (0.3-89 cm3) for Group 3 and 4.40 cm3 (0.2-293 cm3) for Group 4 and the difference was statistically significant (p=0.039). The calculated NIHSS score was 9 (4-23) for the Group 1, 8.5 (3-18) for the Group 2, 6.5 (2-20) for the Group 3, 5 (1-22) for the Group 4 and the effect of anticoagulation use on NIHSS score was statistically significant (p=0.029). Conclusion: Anticoagulant treatment holds importance in the primary and secondary prevention of stroke and in enhancing the NIHSS score and infarct volumes among stroke patients, as evidenced in the current study.