Warfarin vs doac: Comparative outcomes of mechanical thrombectomy for acute ischemic stroke in atrial fibrillation patients.

PURPOSE: To compare outcomes of mechanical thrombectomy (MT) for acute ischemic stroke (AIS) in patients with atrial fibrillation (AF) taking warfarin or direct oral anticoagulants (DOACs).

METHODS: A total of 71 consecutive patients with AF who underwent MT due to AIS between January 2018 and December 2021 were retrospectively analyzed. Patients were grouped as warfarin versus DOAC group. CHA2 DS2 -VASc, HAS-BLED, The National Institutes of Health Stroke Scale (NIHSS) at the time of admission and at 24 h, successful recanalization, post- MT complications and technical properties of MT were evaluated. Patients were divided into a good prognosis group, and a mortality group according to the 90th day mRS.

RESULTS: HAS-BLED score was significantly higher in DOAC group (p = 0.006) There were no significant differences in stroke severity, successful recanalization rates, post-procedural complications and mRS 90th day scores between patients with warfarin and DOACs. CHA2 DS2 -VASc, NIHSS at admission and NIHSS on the 24th hour scores were significantly lower in the good mRS group (p = 0.012, p = 0.002, p < 0.001, respectively).

CONCLUSION: MT is safe and effective in patients receiving warfarin or DOACs. HASBLED and CHA2 DS2 -VASc scores can help to predict functional outcome after MT.