Ischemic Stroke and Periprocedural Discontinuation of Antithrombotic Agents: A Single Center Retrospective Chart Review

Abstract

ABSTRACT

Objective: To investigate the relationship between periprocedural discontinuation of antithrombotics and the occurrence of ischemic stroke in a regional stroke center.

Method: This is a retrospective chart review that examined 517 patients presenting to a regional stroke center with radiographically and/or clinically confirmed ischemic stroke. Prescription to oral antithrombotics at time of stroke and discontinuation for any cause was recorded.

Results: Of the 36 patients who had their antithrombotic therapy interrupted, 6 patients with periprocedural discontinuation and subsequent ischemic stroke (within 30 days) were identified. These patients received anticoagulation therapy with factor Xa inhibitors, direct thrombin inhibitors, or warfarin prior to discontinuation. Adverse bleeding events were identified as the most common reason for discontinuation, followed by non-adherence to medication regimen.

Conclusion: Although the quantity of patients presenting with ischemic stroke following periprocedural anticoagulation interruption was significantly lower than hypothesized, this project nonetheless identifies the need for greater examination into clinician adherence with anticoagulation guidelines and reasons for patient non-compliance.

Key Words: perioperative, periprocedural, antithrombotic, ischemic stroke.