Ischemic stroke in oral anticoagulated patients with atrial fibrillation

2021 ◽  
Author(s):  
Lucio D'Anna ◽  
Filippos T. Filippidis ◽  
Kirsten Harvey ◽  
Eleni Korompoki ◽  
Roland Veltkamp
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Anticoagulated Patients

scholarly journals Efficacy of Oral Anticoagulation in Stroke Prevention among Sinus-Rhythm Patients Who Lack Left Atrial Mechanical Contraction after Cryoablation

2015 ◽  
Vol 42 (5) ◽  
pp. 430-437 ◽  
Author(s):  
José Martínez-Comendador ◽  
Javier Gualis ◽  
José Miguel Marcos-Vidal ◽  
Jonnatan Buber ◽  
Carlos Esteban Martín ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Sinus Rhythm ◽  
Oral Anticoagulation ◽  
Left Atrial ◽  
Fold Increase ◽  
Regression Analyses ◽  
Atrial Contraction ◽  
Anticoagulated Patients

The customary recommendation is that oral anticoagulation be withdrawn a few months after cryoablation for atrial fibrillation, independently of left atrial mechanical contraction in patients in sinus rhythm. Recently, a 5-fold increase in stroke has been described in sinus-rhythm patients who lack atrial mechanical contraction. One aim of this study was to evaluate the efficacy of oral anticoagulation in preventing postoperative stroke in such patients. This prospective study divided 154 sinus-rhythm patients into 2 groups, depending on the presence (108 patients) or absence (46 patients) of left atrial mechanical contraction at 6 months after surgery, and monitored them annually for 5 years. Those without left atrial contraction were maintained on acenocumarol. The primary endpoint was the occurrence of ischemic stroke. The median follow-up period was 29 ± 16 months; 4 patients (2.5%), all belonging to the group with preserved atrial contraction, had ischemic stroke; the group of patients without left atrial contraction had no episodes of stroke during follow-up. Logistic binary regression analyses showed no evidence of factors independently predictive of stroke. Among anticoagulated patients in sinus rhythm without left atrial contraction, we found the incidence of stroke to be zero. In a small, nonrandomized group such as this, we cannot discount the element of chance, yet we suggest that maintaining anticoagulation might lower the incidence of stroke in this population.

scholarly journals Atrial Fibrillation Had Less Impact on the Risk of Ischemic Stroke in Non-anticoagulated Patients Undergoing Hemodialysis: Insight from the RAKUEN study

2018 ◽  
Vol 57 (16) ◽  
pp. 2295-2300 ◽  
Author(s):  
Wataru Mitsuma ◽  
Taku Matsubara ◽  
Katsuharu Hatada ◽  
Shunsuke Imai ◽  
Makoto Tamura ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Anticoagulated Patients

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.

The Role of HbA1c on Mortality in Patients with Medical History of Ischemic Stroke and Paroxysmal Atrial Fibrillation

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 2406-PUB
Author(s):  
KONSTANTINA KANELLOPOULOU ◽  
IOANNIS L. MATSOUKIS ◽  
ASIMINA GANOTOPOULOU ◽  
THEODORA ATHANASOPOULOU ◽  
CHRYSOULA TRIANTAFILLOPOULOU ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Medical History ◽  
Paroxysmal Atrial Fibrillation ◽  
History Of
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