Evaluating Acute Ischemic Strokes despite Regular Anticoagulation: A Comparative Analysis of Direct Oral Anticoagulants and Warfarin in Treatment Outcomes

Abstract

Objective. We aim to compare the outcomes between acute ischemic stroke (AIS) patients under vitamin K antagonist with those under direct oral anticoagulants (DOACs). Methods. This prospective, cross-sectional study was conducted for one year in a tertiary hospital operating as a stroke center. A total of 135 patients receiving oral anticoagulants (DOACs: 98 and VKA: 37) with AIS were included in the study. The patients’ vital parameters, examination and laboratory findings, acute stroke severity scores, stroke localizations, and 3-month clinical outcomes were recorded. Results. Of the 135 patients, 98 (mean age: 76.2, 52 women) were on DOACs while 37 (mean age: 69.7, 26 women) were on VKA. The average age was significantly higher in the group of patients receiving DOACs (p=0.005). Although the mean age of the patient group using DOACs was higher, they did not score worse than patients using VKAs in terms of stroke severity and 3-month outcomes were equal in both groups. The rates of receiving iv-tPA (8.2% and 2.7%, respectively) and thrombectomy rates (23.5% and 29.7%, respectively) were low in the DOACs and VKA groups. Conclusion. The equality in stroke severity and 3-month outcome scores between the DOACs group, characterized by higher average age, and the VKA group is indicative of the comparable efficacy of DOACs in stroke management.