• Elina Pucite Pauls Stradins Clinical University Hospital
  • Kristaps Jurjāns Pauls Stradins Clinical University Hospital
  • Evija Miglāne Pauls Stradins Clinical University Hospital
  • Baiba Luriņa Pauls Stradins Clinical University Hospital
  • Oskars Kalējs Pauls Stradins Clinical University Hospital
  • Andrejs Millers Pauls Stradins Clinical University Hospital
  • Zanda Priede Pauls Stradins Clinical University Hospital
Keywords: Atrial fibrillation, cardio embolic stroke, stroke mortality, primary stroke prevention, secondary stroke prevention


INTRODUCTION: Untreated non-valvular atrial fibrillation is one of major causes of stroke. The goal of the study was to evaluate the use of antithrombotic medication stroke prevention and assess long-term stroke outcome.

METHODS: This study involved 531 cardio embolic stroke patients of the Paul’s Stradins Clinical University Hospital, Riga, Latvia, in 2014. After discharge the patients or their relatives were interviewed by phone after 30, 90, 180, and 365 days. Standardized questions were asked about the patients’ abilities and use of prescribed secondary prevention medication. The results were compared between patient groups, assigned according to prescribed medications.

RESULTS: Of all the patients included in the study, 8.9% were using oral anticoagulants before stroke onset. One year after discharge, 1.44% of patients were not using any preventive medication, 23.56% were using antiplatelet agents, 43.27% warfarin, and 31.73% target-specific oral anticoagulants. The one-year mortality rate was 40.7%. The mortality rate was significantly higher in the patient group using no secondary preventive medication or antiplatelet agents compared to the patient group that used oral anticoagulants.

CONCLUSION: Cardio embolic stroke primary and secondary prevention in Latvia is lacking. The study outcomes suggest that action is needed to increase the use of oral anticoagulants in primary stroke prevention in patients with atrial fibrillation. Poor function outcomes, dementia, and patients’ incompliance limits the use of oral anticoagulants in secondary prevention.


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