Clinical characteristics and outcomes of ischemic stroke in patients receiving non–vitamin K antagonist oral anticoagulants

Deniz Kamacı Şener; Cemile Haki; Tuba Kalkan; Suat Kamışlı

Clinical characteristics and outcomes of ischemic stroke in patients receiving non–vitamin K antagonist oral anticoagulants

Abstract

Aims: Ischemic stroke may still occur despite the use of non–vitamin K antagonist oral anticoagulants (NOACs) in patients with atrial fibrillation. Data regarding the clinical characteristics and outcomes of these patients remain limited. This study aimed to evaluate the clinical characteristics of patients presenting with acute ischemic stroke despite ongoing NOAC therapy and to identify predictors of poor functional outcome. Methods: This retrospective single-center study included 139 patients receiving NOAC therapy who presented with acute ischemic stroke. Demographic, clinical, and treatment-related data were analyzed. Functional outcome at 3 months was assessed using the modified Rankin Scale (mRS), and factors associated with poor outcome were evaluated using multivariate logistic regression analysis. Results: The mean age was 75.5±9.9 years, and 57.6% of patients were female. Most patients (74.8%) were managed with medical treatment alone, while mechanical thrombectomy was performed in 23.0% of patients. Intravenous thrombolysis was rarely used (0.7%). Favorable functional outcome (mRS 0-2) at 3 months was observed in 56.1% of patients. Mechanical thrombectomy was identified as an independent predictor of favorable functional outcome (OR: 0.064, 95% CI: 0.009-0.446, p=0.006). In contrast, higher baseline NIHSS score and CHA₂DS₂-VASc score were independently associated with poor outcome. No significant differences were observed in clinical outcomes according to NOACs type, medication adherence, or dosing appropriateness. Conclusion: Ischemic stroke may still occur in patients receiving NOAC therapy, and its management remains challenging. Mechanical thrombectomy appears to be a key determinant of functional outcome and should be considered in appropriately selected patients. Improving medication adherence and appropriate dosing may also play an important role in patient management.

Keywords

Supporting Institution

none

Ethical Statement

The study was approved by the local ethics committee Bursa City Hospital (Approval number:2026-04/1, Date: 18.02.2026) and conducted in accordance with the Declaration of Helsinki.

Thanks

none

References

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Details

Primary Language

English

Subjects

Neurology and Neuromuscular Diseases

Journal Section

Research Article

Authors

Deniz Kamacı Şener ^*
0000-0003-3433-6859
Türkiye

Cemile Haki
0000-0002-9679-8007
Türkiye

Tuba Kalkan
0009-0004-0298-5568
Türkiye

Suat Kamışlı
0000-0003-4281-3301
Türkiye

Publication Date

June 25, 2026

Submission Date

March 31, 2026

Acceptance Date

May 11, 2026

Published in Issue

Year 2026 Volume: 7 Number: 3

IZ

https://izlik.org/JA97JK84TS

Cite

RIS / Bibtex

APA

Kamacı Şener, D., Haki, C., Kalkan, T., & Kamışlı, S. (2026). Clinical characteristics and outcomes of ischemic stroke in patients receiving non–vitamin K antagonist oral anticoagulants. Journal of Medicine and Palliative Care, 7(3), 491-497. https://izlik.org/JA97JK84TS

AMA

1.Kamacı Şener D, Haki C, Kalkan T, Kamışlı S. Clinical characteristics and outcomes of ischemic stroke in patients receiving non–vitamin K antagonist oral anticoagulants. J Med Palliat Care / JOMPAC / jompac. 2026;7(3):491-497. https://izlik.org/JA97JK84TS

Chicago

Kamacı Şener, Deniz, Cemile Haki, Tuba Kalkan, and Suat Kamışlı. 2026. “Clinical Characteristics and Outcomes of Ischemic Stroke in Patients Receiving Non–vitamin K Antagonist Oral Anticoagulants”. Journal of Medicine and Palliative Care 7 (3): 491-97. https://izlik.org/JA97JK84TS.

EndNote

Kamacı Şener D, Haki C, Kalkan T, Kamışlı S (June 1, 2026) Clinical characteristics and outcomes of ischemic stroke in patients receiving non–vitamin K antagonist oral anticoagulants. Journal of Medicine and Palliative Care 7 3 491–497.

IEEE

[1]D. Kamacı Şener, C. Haki, T. Kalkan, and S. Kamışlı, “Clinical characteristics and outcomes of ischemic stroke in patients receiving non–vitamin K antagonist oral anticoagulants”, J Med Palliat Care / JOMPAC / jompac, vol. 7, no. 3, pp. 491–497, June 2026, [Online]. Available: https://izlik.org/JA97JK84TS

ISNAD

Kamacı Şener, Deniz - Haki, Cemile - Kalkan, Tuba - Kamışlı, Suat. “Clinical Characteristics and Outcomes of Ischemic Stroke in Patients Receiving Non–vitamin K Antagonist Oral Anticoagulants”. Journal of Medicine and Palliative Care 7/3 (June 1, 2026): 491-497. https://izlik.org/JA97JK84TS.

JAMA

1.Kamacı Şener D, Haki C, Kalkan T, Kamışlı S. Clinical characteristics and outcomes of ischemic stroke in patients receiving non–vitamin K antagonist oral anticoagulants. J Med Palliat Care / JOMPAC / jompac. 2026;7:491–497.

MLA

Kamacı Şener, Deniz, et al. “Clinical Characteristics and Outcomes of Ischemic Stroke in Patients Receiving Non–vitamin K Antagonist Oral Anticoagulants”. Journal of Medicine and Palliative Care, vol. 7, no. 3, June 2026, pp. 491-7, https://izlik.org/JA97JK84TS.

Vancouver

1.Deniz Kamacı Şener, Cemile Haki, Tuba Kalkan, Suat Kamışlı. Clinical characteristics and outcomes of ischemic stroke in patients receiving non–vitamin K antagonist oral anticoagulants. J Med Palliat Care / JOMPAC / jompac [Internet]. 2026 Jun. 1;7(3):491-7. Available from: https://izlik.org/JA97JK84TS