Comparison of frequency of silent cerebral infarction as assessed by serum neuron specific enolase in patients with non-valvular atrial fibrillation: Warfarin versus direct oral anticoagulant

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dc.authoridHüseyin Göksülük / 0000-0003-0700-8155en_US
dc.authorscopusidHüseyin Göksülük / 35975940700
dc.authorwosidHüseyin Göksülük / B-4848-2019en_US
dc.contributor.authorGöksülük, Hüseyin
dc.contributor.authorÖzyüncü, Nil
dc.contributor.authorDüzen, İrfan Veysel
dc.contributor.authorVurgun, Veysel Kutay
dc.contributor.authorTan, Türkan Seda
dc.contributor.authorGüleç, Sadi
dc.date.accessioned2022-05-20T11:23:34Z
dc.date.available2022-05-20T11:23:34Z
dc.date.issued2022en_US
dc.departmentİstinye Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümüen_US
dc.description.abstractBackground: Cerebral infarction in patients with atrial fibrillation (AF) may clinically vary from being silent to catastrophic. Silent cerebral infarction (SCI) is the neuronal injury in the absence of clinically appearent stroke or transient ischaemic attack. Serum neuron specific enolase (NSE) is suggested to be a valid surrogate biomarker that allows to detect recent neuronal injury. We aimed to evaluate the incidence of recent SCI by positive NSE levels in patients with non-valvular AF (NVAF) on oral anticoagulants. Methods: Blood samples for NSE were collected from 197 consecutive NVAF patients. NSE levels of greater than 12 ng/ml was considered as positive and suggestive of SCI. Results: Patients were mainly female with a mean age of 69 years. Ninety-eight of them (49.7%) were taking warfarin. Mean INR level was 2.3 ± 0.9. Mean CHA2DS2-VASc score of the study population was 3.5 ± 1.5. Seventy-two patients (36.5%) were found to have NSE elevation. They were more likely to have history of chronic heart failure and previous stroke/TIA. Increased left atrial diameter and higher CHA2DS2-VASc were other factors associated with SCI. Patients on DOACs and patients taking aspirin on top of oral anticoagulant treatment were less likely to have SCI. Multivariate analysis demonstrated that increased left atrial diameter (OR: 2.5; 95% CI: 1.52–4; p < 0.001) and use of warfarin (OR: 2.8; 95% CI: 1.37–5.61; p ¼ 0.005) were detected as independent predictors of SCI. Conclusions: Our study revealed that DOACs were associated with significantly reduced SCIs compared with warfarin, probably due to more effective and consistent therapeutic level of anticoagulation.en_US
dc.identifier.citationGoksuluk H, Ozyuncu N, Duzen IV, Vurgun VK, Tan TS, Gulec S. Comparison of frequency of silent cerebral infarction as assessed by serum neuron specific enolase in patients with non-valvular atrial fibrillation: Warfarin versus direct oral anticoagulant. Acta Cardiol. 2022 Apr 25:1-7. doi: 10.1080/00015385.2022.2066777. Epub ahead of print. PMID: 35469540.en_US
dc.identifier.doi10.1080/00015385.2022.2066777en_US
dc.identifier.issn0001-5385en_US
dc.identifier.pmid35469540en_US
dc.identifier.scopus2-s2.0-85130056356en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.urihttp://doi.org/10.1080/00015385.2022.2066777
dc.identifier.urihttps://hdl.handle.net/20.500.12713/2682
dc.identifier.volume77en_US
dc.identifier.wosWOS:000787702600001en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.institutionauthorGöksülük, Hüseyin
dc.language.isoenen_US
dc.publisherTaylor and Francisen_US
dc.relation.ispartofActa Cardiologiaen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectAtrial Fibrillationen_US
dc.subjectNeuron Specific Enolaseen_US
dc.subjectOral Anticoagulant Treatmenten_US
dc.subjectSilent Cerebral Infarctionen_US
dc.titleComparison of frequency of silent cerebral infarction as assessed by serum neuron specific enolase in patients with non-valvular atrial fibrillation: Warfarin versus direct oral anticoagulanten_US
dc.typeArticleen_US

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