The Prevalence of Prescription of New Anticoagulant Drugs and Its Determinant Factors in Patients With Ischemic Stroke and Non-valvular Atrial Fibrillation

Abstract

Background: Patients with ischemic stroke and underlying Atrial Fibrillation (AF) have a high risk of recurrent embolic events. New Oral Anticoagulant (NOAC) is highly effective and reduces the risk of recurrence in AF-associated Ischemic Stroke (AFAIS). Objectives: This study aimed to determine the prescription pattern of NOAC and its determinant factors in patients with non-valvular AFAIS. Materials & Methods: This research was a cross-sectional descriptive study and the participants were referred to an academic hospital in the north of Iran from 2017 to 2018. The study variables included demographic variables such as the use of new anticoagulants, age, sex, place of residence, income level, education, the history of stroke and myocardial Infarction (MI), medication, and stroke severity based on The National Institutes of Health Stroke Scale criteria. The patient’s functional status based on the modified Rankin Scale (mRS) was extracted from the patients’ medical records. The data analysis was conducted by SPSS V. 19, using the Chi-square test and t-test, as well as the logistic regression model. Results: In this study, 363 patients with ischemic stroke with the origin of non-valvular AF and the mean age of 67.87 years were studied. Of them, 191 (52.6%) patients were women, and 30.6% were prescribed rivaroxaban at the time of discharge. The results showed that women were more likely to use rivaroxaban than men (P=0.001, OR=0.422). The history of stroke (P=0.004, OR=2.17) and the stroke severity (P=0.05, OR=2.19) was associated with an increase in NOAC prescription. Conclusion: The results of this study showed that the administration of NOAC in this population was low and associated with gender and the severity and the history of stroke.