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Acute ischemic stroke or TIA despite DOAC treatment: the contribution of DOAC plasma levels to understand pathophysiological mechanisms

Title: Acute ischemic stroke or TIA despite DOAC treatment: the contribution of DOAC plasma levels to understand pathophysiological mechanisms
Authors: Rust, Marcus; Gözalan, Merve; Nikoubashman, Omid; Wiesmann, Martin; Imöhl, Matthias; Schulz, Jörg B.; Reich, Arno; Pinho, João
Publisher Information: Sage
Publication Year: 2026
Collection: PUB - Publications at Bielefeld University
Description: Rust M, Gözalan M, Nikoubashman O, et al. Acute ischemic stroke or TIA despite DOAC treatment: the contribution of DOAC plasma levels to understand pathophysiological mechanisms. Therapeutic Advances in Neurological Disorders . 2026;19. ; Background: Ischemic stroke or transient ischemic attack (TIA) occurs in 1.4% of patients with atrial fibrillation (AF) per year despite treatment with direct oral anticoagulants (DOACs). This group of patients is poorly studied, and possible causes for this are not fully understood.; Objectives: The aim of the study was to analyze DOAC plasma levels in patients who had ischemic stroke or TIA despite treatment with DOAC.; Design: Monocentric retrospective study.; Methods: We selected consecutive DOAC-treated patients with acute ischemic stroke or TIA, admitted during a 2-year period, with measurement of DOAC levels ⩽24h after hospital admission. Patients with and without low DOAC levels (48h before admission (72.5% vs 57.5%, p=0.004), and had higher baseline NIHSS (8 vs 4, p=0.001). Lower DOAC levels were associated with large or medium vessel occlusion (LVO/MeVO; odds ratio per 10ng/mL-increase=0.89, 95% confidence interval=0.85-0.94, p
Document Type: article in journal/newspaper
Language: English
ISSN: 1756-2856; 1756-2864
Relation: info:eu-repo/semantics/altIdentifier/issn/1756-2856; info:eu-repo/semantics/altIdentifier/issn/1756-2864; info:eu-repo/semantics/altIdentifier/wos/001688208200001; info:eu-repo/semantics/altIdentifier/pmid/41696675
Availability: https://pub.uni-bielefeld.de/record/3014214
Rights: info:eu-repo/semantics/closedAccess
Accession Number: edsbas.6ECABD73
Database: BASE