正在服用非维生素K拮抗剂口服抗凝药物（NOAC）的患者中，缺血性卒中（IS）的发生越来越频繁。我们的目标是确定在服用NOAC治疗心房颤动的患者中出现IS的临床、超声心动图和神经影像学标志物。从四级护理中心，连续收集IS患者和无IS的年龄匹配对照组的临床/放射学数据。对大脑核磁共振成像进行回顾性研究以寻找脑小血管病变的标志物。将两组之间有显著差异的变量输入多变量回归模型以确定IS的预测因素。在IS患者中，构建Cox回归分析以确定随访期间IS复发的预测因素。研究包括112名有IS的患者和94名对照组。两组之间显著差异的变量包括阿比替南使用、达比加群使用、先前的脑血管事件、血红蛋白A1c（HbA1c）水平、左室肥厚、左房容量指数和严重的白质高信号。在多变量调整后，先前的脑血管事件（aOR 23.86，95％CI [6.02-94.48]），HbA1c水平（aOR 2.36，95％CI [1.39-3.99]），左室肥厚（aOR 2.73，95％CI [1.11-6.71]）和左房容量指数（aOR 1.05，95％CI [1.01-1.08]）增加了卒中风险，而阿比替南使用似乎降低了风险（aOR 0.38，95％CI [0.16-0.92]）。调整后，恶性肿瘤与IS复发有关（aHR 4.90，95％CI [1.35-18.42]），调整了年龄和慢性肾衰竭。先前的脑血管事件、糖尿病、左室肥厚和左房增大是NOAC用户发生IS的风险因素。© 2023. 作者(们)在Springer-Verlag GmbH Germany独家授权下。

Ischemic strokes (IS) occurring in patients taking non-vitamin K antagonist oral anticoagulants (NOACs) are becoming increasingly more frequent. We aimed to determine the clinical, echocardiographic, and neuroimaging markers associated with developing IS in patients taking NOACs for atrial fibrillation.From a quaternary care center, clinical/radiologic data were collected from consecutive NOAC users with IS and age-matched controls without IS. Brain MRIs were reviewed for markers of cerebral small vessel disease. Variables with significant differences between groups were entered into a multivariable regression model to determine predictors of IS. Among IS patients, a Cox regression analysis was constructed to determine predictors of IS recurrence during follow-up.112 patients with IS and 94 controls were included in the study. Variables significantly different between groups included apixaban use, dabigatran use, prior cerebrovascular events, hemoglobin A1c (HbA1c), left ventricular hypertrophy, left atrial volume index, and severe white matter hyperintensities. After multivariable adjustment, prior cerebrovascular events (aOR 23.86, 95% CI [6.02-94.48]), HbA1c levels (aOR 2.36, 95% CI [1.39-3.99]), left ventricular hypertrophy (aOR 2.73, 95% CI [1.11-6.71]) and left atrial volume index (aOR 1.05, 95% CI [1.01-1.08]) increased the risk of stroke, whereas apixaban use appeared to decrease the risk (aOR 0.38, 95% CI [0.16-0.92]). Malignancy was associated with IS recurrence (aHR 4.90, 95% CI [1.35-18.42]) after adjustment for age and chronic renal failure.Prior cerebrovascular events, diabetes, left ventricular hypertrophy, and increased left atrial size are risk factors for developing an IS among NOAC users.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.