Related Experiment Video

Updated: May 28, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

Improvement in use of anticoagulation therapy in patients with ischemic stroke: results from Get With The

William R Lewis1, Gregg C Fonarow, Maria V Grau-Sepulveda

  • 1MetroHealth Campus, Case Western Reserve University, Cleveland, OH 44109, USA. wlewis@metrohealth.org

American Heart Journal
|October 11, 2011
PubMed

Insights

Anticoagulation therapy for atrial fibrillation (AF) stroke patients is increasingly used, reaching 95.2% in the Get With The Guidelines-Stroke program. Efforts should now target specific patient groups for improved anticoagulation use.

Area of Science:

  • Cardiology
  • Neurology
  • Public Health

Background:

  • Anticoagulation therapy is crucial for reducing thromboembolic events in atrial fibrillation (AF) patients.
  • It has a class I indication for ischemic stroke patients with AF, barring contraindications.

Purpose of the Study:

  • To determine patient and hospital characteristics associated with increased anticoagulation use in AF patients with stroke or TIA.
  • To evaluate the impact of the Get With The Guidelines-Stroke (GWTG-Stroke) program on anticoagulation practices.

Main Methods:

  • Assessed anticoagulation use at hospital discharge for eligible AF patients with stroke/TIA.
  • Analyzed data from 1,354 hospitals between April 2003 and April 2010.
  • Examined patient demographics, hospital characteristics, and program participation.

Main Results:

  • Among 197,778 AF patients, 47.6% were eligible for anticoagulation, with 94.0% receiving it at discharge.
  • Older, African American, Hispanic, and diabetic patients were less likely to receive anticoagulation.
  • Anticoagulation use increased from 88.4% to 95.2% (P < .0001) during the study period, associated with GWTG-Stroke participation.

Conclusions:

  • Anticoagulation use in stroke patients with AF has significantly increased within the GWTG-Stroke program.
  • Future strategies should focus on enhancing anticoagulation use in underrepresented patient populations.
Abstract

Related Concept Videos

Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants

Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
Venous Thrombosis IV: Nursing Management01:30

Venous Thrombosis IV: Nursing Management

Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...