Incidence of Acute Ischemic Stroke in Hospitalized Patients
Atrial fibrillation (AF) is one of the leading causes of acute ischemic stroke requiring anticoagulation. Many patients experience treatment interruption in the hospital setting. The aim of this study was to evaluate the effect of anticoagulation interruption on short-term risk of ischemic stroke in hospitalized patients with AF.

Researchers performed a retrospective medical record review using the Hospital Corporation of America (HCA) database. They included patients who had a prior history of AF. Patients were excluded if they had ischemic stroke, hemorrhagic stroke, history venous thromboembolism or mechanical valve on admission. They compared the incidence of ischemic stroke in patients in whom anticoagulation was interrupted for more than 48 h to those who continued anticoagulation.

-- A total of 2,277 patients with history of AF were included in the study.

-- In this cohort, 79 patients (3.47%) had anticoagulation interruption of more than 48 h during their hospital stay.

-- There was no difference in incidence of stroke between the interruption and no interruption groups (1.27% (n = 1) vs. 0.23%).

-- Interruption of anticoagulation did not associate with a significant increase in the risk of in-hospital ischemic stroke.

-- CHA2DS2VASc score was a strong predictor of in-hospital stroke risk regardless of anticoagulation interruption.

Conclusively, in this study, the in-hospital incidence of ischemic stroke in patients with AF did not significantly increase by short-term anticoagulation interruption.