Analysis of recurrent stroke volume and prognosis between warfarin and four NOACs (non-vitamin K antagonist oral anticoagulants) administration for secondary prevention of stroke.

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Objective. We investigated recurrent stroke volume with nonvalvular atrial fibrillation (NVAF) patients treated with non-vitamin K antagonist oral anticoagulants (NOACs) about clinical backgrounds and number of recurrent stroke.
Methods. We administered four NOACs, dabigatran, rivaroxaban, apixaban and edoxaban in 101 post cardioembolic stroke with NVAF. In retrospective study, we measured recurrent stroke volume with MRI volumetric soft and compared them between 10 vitamin K anticoagulant (VKA: warfarin) cases and 13 NOACs cases under anticoagulant therapy.
Results. Of 101 cases, 31 cases were started with VKA and switched to NOACs after 10 recurrent strokes. Other 70 cases were directly started with NOACs and 13 cases with NOACs as first anticoagulants had recurrent stroke. The frequency of recurrent stroke during anticoagulant therapy are not different among VKA group and three NOACs group. Recurrent stroke volume is significantly larger in VKA group (26.4 cm3) than in NOACs group (3.8cm3).
Conclusions. Secondary prevention with NOACs after stroke might be more beneficial by reducing recurrent infarct volume than VKA.