Abstract Details

Title Triglycerides, Creatinine and Body Mass Index are Independent Predictors of Occurrence of Stroke in Patients Adherent with Direct Oral Anticoagulant

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P1 - Poster Session 1 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-002

Objective

We sought to determine whether certain variables are predictive of the occurrence of stroke in patients on direct oral anticoagulants (DOAC).

Background

DOAC are alternatives to warfarin for the prevention of stroke in patients with nonvalvular atrial fibrillation (NVAF). However embolic strokes were observed in some patients who remain adherent with DOAC.

Design/Methods A case control study was conducted from November 2011 to July 2018. Patients admitted to the Buffalo General Medical Center with embolic stroke adherent with apixaban, rivaroxaban or dabigatran were included. Age, gender and race matched controls include NVAF patients on DOACs without stroke. Past medical history, laboratory and demographics were obtained. Statistical analysis was conducted using R v.1.1.456. Independent T tests were applied for continuous and Chi Square for categorical variables. Logistic regression was used to assess whether certain variables were predictive of stroke. P-value of < 0.05 was considered statistically significant.

Results A total of 23 patients adherent with DOAC were admitted with stroke. Of these, 13 were on apixaban, 6 on rivaroxaban, 4 on dabigatran. Mean age (mean ±SD) was 74 ± 2, 13 (56%) were male, 20 (87%) Caucasian and 3 (13%) African American. The control pool consisted of 555 patients. Significant baseline differences between study patients and the controls include: triglycerides (134 vs. 90, p = 0.01), A1c (6.3 vs. 5.7, p = 0.03), creatinine (1.19 vs. 0.91, p = 0.01), and BMI (32.4 vs. 26.3, p = 0.01). After multivariate analysis triglycerides (RR = 1.03, p = 0.05), creatinine (RR = 33, p = 0.02) and BMI (RR = 1.24, p = 0.04) were significant predictors.

Conclusions

In summary, triglycerides, creatinine and BMI were found to be independent predictors of embolic stroke in patients’ adherent with DOAC in our study population. Data collection is ongoing to further our findings.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
Thomas N. Leahy, MD	Dr. Leahy has nothing to disclose.
Harshit Shah, MD	No disclosure on file
Haris Kamal, MD (University of Texas At Houston)	Dr. Kamal has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Microvention .
Marilou I. Ching, MD (Chingbingyong)	Dr. Ching has nothing to disclose.

��ɫ��

��ɫ��