Supplementary Material for: Portuguese Observational Study of Ischaemic Stroke in Patients Medicated with Non-Vitamin K Antagonist Oral Anticoagulants

<b><i>Introduction:</i></b> Clinical trials and subsequent meta-analyses showed advantages of non-vitamin K antagonists oral anticoagulants (NOACs) over vitamin K antagonists (VKAs) in patients with non-valvular atrial fibrillation. The impact of preadmission anticoagulation in acute ischaemic stroke (AIS) has not been established. <b><i>Objective:</i></b> To compare functional outcome of patients with AIS with preadmission NOACs vs. VKAs. <b><i>Methods:</i></b> A retrospective analysis was conducted on consecutive AIS patients under oral anticoagulation (VKAs or NOACs) admitted in 4 Portuguese hospitals within a period of 30 months. Two primary outcomes were defined and compared between VKA and NOAC groups: symptomatic intracerebral hemorrhage transformation (sICH) and modified Rankin Scale (mRS) at 3 months. <b><i>Results:</i></b> Four hundred sixty-nine patients were included, of whom 332 (70.8%) were treated with VKA and 137 (29.2%) with NOAC. Patients’ median age was 78.0 and 234 (49.9%) were male. NOAC-treated patients had a higher median CHA₂DS₂-VASc score than those under VKA (5.0 vs. 4.0, <i>p</i> = 0.023). The two primary outcomes showed no statistical differences between the VKAs’ group and the NOACs’ group (sICH: 5.4 vs. 5.4% [<i>p</i> = 0.911]; mRS at 3 months: 3.0 vs. 3.0 [<i>p</i> = 0.646], respectively). <b><i>Conclusion:</i></b> Preadmission anticoagulation with NOACs in AIS has a functional impact similar to that of VKAs.

<b><i>引言：</i></b> 临床试验及后续荟萃分析结果显示，针对非瓣膜性心房颤动患者，非维生素K拮抗剂口服抗凝药（non-vitamin K antagonists oral anticoagulants, NOACs）的疗效优于维生素K拮抗剂（vitamin K antagonists, VKAs）。目前，入院前抗凝治疗对急性缺血性脑卒中（acute ischaemic stroke, AIS）的临床影响尚未明确。
<b><i>研究目的：</i></b> 对比入院前接受NOACs与VKAs治疗的急性缺血性脑卒中患者的功能预后。
<b><i>研究方法：</i></b> 本研究对30个月内于4家葡萄牙医院收治的、连续入组的接受口服抗凝治疗（VKAs或NOACs）的急性缺血性脑卒中患者开展回顾性分析。设定两项主要结局指标以对比VKA组与NOAC组患者的结局：症状性颅内出血转化（symptomatic intracerebral hemorrhage transformation, sICH）以及3个月时的改良Rankin量表（modified Rankin Scale, mRS）评分。
<b><i>研究结果：</i></b> 本研究共纳入469例患者，其中332例（70.8%）接受VKA治疗，137例（29.2%）接受NOAC治疗。受试者中位年龄为78.0岁，其中234例（49.9%）为男性。接受NOAC治疗的患者的中位CHA₂DS₂-VASc评分高于VKA组患者（5.0 vs 4.0，<i>p</i>=0.023）。两项主要结局指标在VKA组与NOAC组间均未体现出统计学差异（症状性颅内出血转化：5.4% vs 5.4%，<i>p</i>=0.911；3个月时改良Rankin量表评分：3.0 vs 3.0，<i>p</i>=0.646）。
<b><i>研究结论：</i></b> 急性缺血性脑卒中患者入院前接受NOACs抗凝治疗，其功能预后与VKAs治疗相当。