Prevalence of Ischemic Versus Hemorrhagic Stroke in Patients Taking Anti-Coagulation Therapy

Nasrullah Aamer; Muhammad  Nouman; Shahid Hussain  Memon; Zaheer  Hussain Memon; Shaista  Ahmed; Hira Saeed Khan

doi:10.35787/jimdc.v13i2.1224

Nasrullah Aamer Professor of Medicine, Peoples University of Medical and health Sciences Nawabshah
Muhammad Nouman Assistant Professor of Medicine, Indus Medical College, TM Khan Pakistan
Shahid Hussain Memon Associate Professor of Cardiology, LUMHS Jamshoro Pakistan
Zaheer Hussain Memon Associate Professor of Medicine, Suleman Roshan Medical College, Tando Adam Pakistan
Shaista Ahmed Professor (officiating), Karachi Medical and Dental College
Hira Saeed Khan Assistant Professor of Physiology, Suleman Roshan Medical College, Tando Adam Pakistan

DOI: https://doi.org/10.35787/jimdc.v13i2.1224

Abstract

OBJECTIVE: To evaluate the prevalence of ischemic versus hemorrhagic stroke in patients taking anti-coagulation therapy.

PATIENTS AND METHODS: This cross-sectional prospective study was conducted at medicine Departments of Peoples University of Medical & Health Sciences (PUMHS), for a period of 18 months from September 2021 to January 2023. All the patients taking anti-thrombotic therapy (warfarin, rivaroxaban, dabigatran, or apixaban) were included in this study and their baseline and clinical data were collected. Statistical package for the social sciences version (SPSS v. 26) was used for data entry and data analysis. Chi-square test/fisher’s exact and independent t-test test was used for determination of risk factors associated with hemorrhagic or ischemic strokes. A p value of <0.05 was considered as statistically significant.

RESULTS: A total of 296 patients were enrolled for final analysis. The overall mean age, BMI, and duration of anticoagulation therapy was 62.14±8.44 years, 25.38±3.19 kg/m², and 8.34±12.51 months. Among all study participants, 57.43% (n = 170) were taking NOACs while 42.56% (n = 126) were taking warfarin. The overall prevalence of stroke was 14.18% (n = 42) and among them hemorrhagic stroke was more common (57.14%, n = 27) than ischemic stroke (35.71%, n = 15). Patients taking NOACs were more likely to have hemorrhagic stroke as compared to ischemic stroke, 74.07% (n = 20/27) and 40.0% (n = 7), respectively, p value <0.001.

CONCLUSION: The risk of stroke is quite high in patients receiving anti-thrombotic therapies. Hemorrhagic stroke is higher in patients receiving NOACs

KEYWORDS: Anti-thrombotic therapy, ischemic stroke, hemorrhagic stroke, Pakistan