A Match Made Unequal: Impact of Oral Anticoagulants on Stroke Outcomes Following Propensity Score Matching

• DOI: 10.20944/preprints202501.1449.v1
• Publication Date: 2025-01-22T01:14:11Z
• Authors: Jessica Seetge; Balázs Cséke; Zsófia Nozomi Karádi; Edit Bosnyák; László Szapáry
• Keywords: Stroke

Background/Objectives: Oral anticoagulants (OACs) are commonly used for stroke prevention in patients with atrial fibrillation (AF), but their impact on long-term outcomes following acute ischemic (AIS) remains uncertain. This study evaluated whether prior anticoagulation influences functional and mortality AIS patients. Methods: A total of 914 admitted to the Department Neurology, University Pécs, an from January 2023 September 2024, were retrospectively reviewed. Patients categorized into anticoagulated group (OAC use, n=153) a non-anticoagulated (Non-OAC n=761). Caliper-matched propensity score matching (PSM) was performed balance confounding factors, including age, sex, history hypertension or diabetes mellitus, severity at 72 hours (assessed by National Institutes Health Stroke Scale [NIHSS] score) pre-stroke disability (based pre-morbidity modified Rankin [pre-mRS] score). Analyses conducted two key outcomes: 90-day mRS (modified Scale) scores mortality. Results: After matching, 276 analyzed 306 Anticoagulated 2.26 times more likely have unfavorable outcome (90-day >2) compared (p=0.043). No significant difference (mRS = 6) observed between groups (p=0.307). Advanced age higher 72h-NIHSS predictors poor outcomes, regardless status. Conclusions: Prior associated without reducing While OACs remain essential AF patients, these findings suggest that benefit must be weighed against risk increased AIS.