Abstract Number: Esoc2026lb83 Long-term Outcomes After Ischemic Stroke in Patients With Atrial Fibrillation Under Oral Anticoagulation
Year: 2026
Type: conference-abstract
Abstract: Background and aims Breakthrough stroke despite oral anticoagulation (OAC) for atrial fibrillation (AF) is associated with unfavorable prognosis. We assessed the long-term outcomes and treatment-related prognostic factors of patients with stroke under OAC for AF. Methods Prospective data from consecutive patients with anterior ischemic stroke, AF and carotid imaging from 10 stroke registries were included. Outcomes assessed were stroke recurrence, major adverse cardiovascular events (MACE), and mortality. Multivariable Cox-regression was performed to identify independent predictors for every outcome. Results Among 2,551 patients, 1,725 discharged on OAC. At 5 years, 9.6% experienced a recurrence, 33.4% a MACE and 27.2% died. Patients with breakthrough stroke had higher risk of recurrence at 12 months (HR 2.14; 95%CI 1.17–3.89) and 5 years (HR 2.06; 95%CI 1.32–3.22). At 5 years, breakthrough stroke was independently associated with increased MACE risk (HR 1.37; 1.06–1.79). Compared with vitamin K antagonists, DOACs were associated with lower stroke (HR 0.57; 0.33–1.00) and MACE risk (HR 0.69; 0.50–0.95). Statins were associated with lower risk of stroke (HR 0.68; 0.46–0.99), MACE (HR 0.65; 0.52–0.81), and mortality (HR 0.52; 95%CI 0.39–0.68). Advanced age (HR 1.06/year; 1.04–1.07), diabetes (HR 1.53; 1.16–2.02), coronary artery disease (HR 1.51; 1.11–2.06), and cancer (HR 3.16; 2.12–4.71) were associated with higher mortality. Conclusions Patients with breakthrough stroke despite OAC treatment represent a high-risk population with significantly worse long-term outcomes. DOAC and statin therapy remain the standard of care and warrant emphasis in secondary prevention strategies. Conflict of interest
Source: European Stroke Journal
Authors: Dimitrios Sagris, Eleni Korompoki, Anastasia Adamou, Davide Strambo, Patrik Michel, Konstantinos Vemmos, Clara Lastras, Blanca Fuentes, Exuperio Díez-Tejedor, Paula Tiili, Mika Lehto, Elisa Cuadrado-Godia, Esmirna Farington-Terrero, Antonio Arauz Gongora, Hooman Kamel, Julieta Soledad Rosales, Maia Gomez-Schneider, A Barboza Miguel, Alexander Tsiskaridze, George Ntaios
Institutions: University of Thessaly, University Hospital of Larissa, Alexandra Hospital, AHEPA University Hospital, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Hospital Universitario La Paz, Hospital La Paz Institute for Health Research, Universidad Autónoma de Madrid, University of Helsinki, Helsinki University Hospital, Universitat Pompeu Fabra, Hospital Del Mar, Instituto Nacional de Neurología y Neurocirugía, Weill Cornell Medicine, Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia, Costa Rican Department of Social Security, Universidad de Costa Rica, Tbilisi State University
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,400
OpenAlex ID: W7160422362
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