Ischemic stroke and non-valvular atrial fibrillation: When to introduce anticoagulant therapy?

2020 ◽  
Vol 45 (2) ◽  
pp. 72-80
Author(s):  
V. Boursier-Bossy ◽  
M. Zuber ◽  
J. Emmerich
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Anticoagulant Therapy

Anticoagulant therapy in practice

2012 ◽  
Vol 153 (19) ◽  
pp. 732-736
Author(s):  
Gergely Hofgárt ◽  
Csilla Vér ◽  
László Csiba
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Acute Stroke ◽  
Anticoagulant Therapy ◽  
Oral Anticoagulants ◽  
Health Science ◽  
Science Centre ◽  
Improper Use ◽  
Current Guidelines

Atrial fibrillation is a risk factor for ischemic stroke. To prevent stroke oral anticoagulants can be administered. Old and new types of anticoagulants are available. Nowadays, old type, acenocumarol based anticoagulants are used preferentially in Hungary. Aim: The advantages and the disadvantages of anticoagulants are well known, but anticoagulants are underused in many cases. Method: The authors retrospectively examined how frequent atrial fibrillation was and whether the usage of anticoagulants in practice was in accordance with current guidelines among acute stroke cases admitted to the Department of Neurology, Medical and Health Science Centre of Debrecen University in 2009. Results: Of the 461 acute stroke cases, 96 patients had known and 22 patients had newly discovered atrial fibrillation. Half of the patients did not receive proper anticoagulation. Only 8.4% of them had their INR levels within the therapeutic range. Conclusions: The findings are similar to those reported in other studies. Many factors may contribute to the high proportion of improper use of anticoagulants, and further investigations are needed to determine these factors. In any case, elimination of these factors leading to a failure of anticoagulation may decrease the incidence of stroke. Orv. Hetil., 2012, 153, 732–736.

scholarly journals 407: Not all patients with atrial fibrillation associated ischemic stroke can be started on anticoagulant therapy

2007 ◽  
Vol 14 (10) ◽  
pp. 1016-1017
Author(s):  
Jennifer A. Somerfield ◽  
Alan P. Barber ◽  
Neil E. Anderson ◽  
Ajay Kumar ◽  
David Spriggs ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Anticoagulant Therapy

scholarly journals Mechanical thrombextraction in patient with acute ischemic stroke on background of oral anticoagulant therapy

2021 ◽  
pp. 36-40
Author(s):  
V.О. Yarosh ◽  
◽  
V.V. Babenko ◽  
O.E. Svyrydiuk ◽  
O.J. Zharinov ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Acute Ischemic Stroke ◽  
Anticoagulant Therapy ◽  
Oral Anticoagulant ◽  
Oral Anticoagulant Therapy ◽  
Interventional Treatment ◽  
Key Words Ischemic Stroke

Thrombolytic therapy, which is a priority treatment strategy in patients with acute ischemic stroke in the first 3-4.5 hours after start of the disease, has significant limitations in case of background anticoagulant therapy. Mechanic thrombextraction is considered to be an alternative therapeutic strategy in case of inefficacy or contraindications to thrombolytic therapy. The article presents a clinical case of the 75-year old female patient with acute cardioembolic stroke on background of heart failure and atrial fibrillation. Long-term background usage of the direct oral anticoagulant due to atrial fibrillation is a limitation to use thrombolytic therapy, therefore mechanical thrombextraction was performed. The case presents possibilities of the successful interventional treatment of acute cardioembolic ischemic stroke. An example of a possible drug-drug interaction possibly leading to reduction of the effectiveness of anticoagulant therapy is shown. Key words: ischemic stroke, anticoagulants, mechanical trombextraction.

scholarly journals Efficacy and safety of anticoagulant therapy in real clinical practice in patients with persistent atrial fibrillation after interventional treatment

2021 ◽  
Vol 28 (3) ◽  
pp. 21-27
Author(s):  
O. R. Eshmatov ◽  
R. E. Batalov ◽  
M. A. Dragunova ◽  
E. A. Archakov ◽  
S. V. Popov
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Anticoagulant Therapy ◽  
Medical Center ◽  
Persistent Atrial Fibrillation ◽  
Interventional Treatment ◽  
Efficacy And Safety ◽  
Thromboembolic Complications ◽  
Cryo Ablation

Aim. To study the efficacy and safety of anticoagulant therapy in patients with persistent atrial fibrillation (AF) after interventional treatment during 36 months of follow-up.Material and methods. The study included 135 patients (78 men and 58 women) in the age from 31 to 80 years (mean age 61.0 [55; 66]) with persistent AF who underwent catheter treatment. All patients were treated in the arrhythmia department of the Research Institute of Cardiology (Tomsk National Research Medical Center from 01.01.2017 to 31.12.2017.Results. In patients with persistent AF, the effectiveness of catheter treatment was 60% after 12 months of follow-up (81 patients had no documented AF during this period) and 63.7 % (n=86) - after 24 and 36 months. No fatal outcomes, myocardial infarction, or ischemic stroke were observed within 12 months after catheter treatment in patients with an effective procedure. During 36 months of follow-up, the incidence of ischemic stroke on the background of receiving anticoagulant therapy and effective catheter treatment of persistent AF was significantly lower than in patients with unsuccessful ablation (1.16% and 10%, respectively), even though not all patients from the first group received prescribed medication.Conclusion. Successful radiofrequency procedure/cryo-ablation of AF persistent form significantly reduced the risk of ischemic stroke from 10% to 1.16% and almost eliminated the likelihood of other thromboembolic complications, while the invasive strategy did not increase the risk of large and small bleeding in this group of patients.

scholarly journals Incidence of complications of antithrombotic treatment in patients with atrial fibrillation

2013 ◽  
Vol 66 (11-12) ◽  
pp. 470-475
Author(s):  
Sladjana Novakovic-Anucin ◽  
Sanja Gnip ◽  
Visnja Canak ◽  
Pavica Radovic ◽  
Jelena Kovacev ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Anticoagulant Therapy ◽  
Vitamin K ◽  
Oral Anticoagulant Therapy ◽  
Vitamin K Antagonists ◽  
Combined Treatment ◽  
Thromboembolic Complications ◽  
Antithrombotic Treatment ◽  
Hemorrhagic Complications

Introduction. Atrial fibrillation increases the risk of ischemic stroke five fold, while the application of long-term anticoagulant therapy is associated with the occurrence of hemorrhagic complications. The aim of our study was to evaluate the incidence of thrombotic and hemorrhagic complications in patients with atrial fibrillation during antithrombotic treatment. Material and Methods. The study included 504 patients that were administered the primary (n=345) or secondary thromboprophylaxis after ischemic stroke (n=159), by applying vitamin K antagonists, or the combination of vitamin K antagonists and low-dose aspirin. The patients were followed for five months in the period of 24 years from 1988 to 2012, the total number of patient?s years being 1884, at the Clinical Center of Vojvodina. Thromboembolic and hemorrhagic complications were registered during regular check-up examinations. Results and Discussion. Our results indicate the low incidence of thromboembolic complications (0.01 patient per a year), with a lower incidence in the vitamin K antagonists group than in the group with the combination of vitamin K antagonists and aspirin (0.008 patient per a year versus 0.01 patient per a year). The incidence of hemorrhagic complications was higher in the group with the combined treatment compared to the group treated with vitamin K antagonists (0.1 patient per a year versus 0.06 patient per a year). The frequency of major bleeding was as low as 0.01 patient per a year and more frequent in the group with combined treatment (0.03 patient per a year). Conclusion. The overall incidence of complications in the study group was 0.08 patient per a year. The combined antithrombotic treatment increases the risk of hemorrhagic complications and affects the severity of bleeding. Oral anticoagulant therapy is more efficient in the prevention of ischemic stroke and thromboembolic complications in patients with atrial fibrillation.

scholarly journals Not All Patients With Atrial Fibrillation–Associated Ischemic Stroke Can Be Started on Anticoagulant Therapy

Stroke ◽  
2006 ◽  
Vol 37 (5) ◽  
pp. 1217-1220 ◽  
Author(s):  
Jennifer Somerfield ◽  
P. Alan Barber ◽  
Neil E. Anderson ◽  
Ajay Kumar ◽  
David Spriggs ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Anticoagulant Therapy
Sign in / Sign up

Export Citation Format

Share Document