Antithrombotic Medication for Cardioembolic Stroke Prevention
Embolism of cardiac origin accounts for about 20% of ischemic strokes. Nonvalvular atrial fibrillation is the most frequent cause of cardioembolic stroke. Approximately 1% of population is affected by atrial fibrillation, and its prevalence is growing with ageing in the modern world. Strokes due to...
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| Format: | Article |
| Language: | English |
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Wiley
2011-01-01
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| Series: | Stroke Research and Treatment |
| Online Access: | http://dx.doi.org/10.4061/2011/607852 |
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| author | M. Àngels Font Jerzy Krupinski Adrià Arboix |
| author_facet | M. Àngels Font Jerzy Krupinski Adrià Arboix |
| author_sort | M. Àngels Font |
| collection | DOAJ |
| description | Embolism of cardiac origin accounts for about 20% of ischemic strokes. Nonvalvular atrial fibrillation is the most frequent cause of cardioembolic stroke. Approximately 1% of population is affected by atrial fibrillation, and its prevalence is growing with ageing in the modern world. Strokes due to cardioembolism are in general severe and prone to early recurrence and have a higher long-term risk of recurrence and mortality. Despite its enormous preventive potential, continuous oral anticoagulation is prescribed for less than half of patients with atrial fibrillation who have risk factors for cardioembolism and no contraindications for anticoagulation. Available evidence does not support routine immediate anticoagulation of acute cardioembolic stroke. Anticoagulation therapy's associated risk of hemorrhage and monitoring requirements have encouraged the investigation of alternative therapies for individuals with atrial fibrillation. New anticoagulants being tested for prevention of stroke are low-molecular-weight heparins (LMWH), unfractionated heparin, factor Xa inhibitors, or direct thrombin inhibitors like dabigatran etexilate and rivaroxaban. The later exhibit stable pharmacokinetics obviating the need for coagulation monitoring or dose titration, and they lack clinically significant food or drug interaction. Moreover, they offer another potential that includes fixed dosing, oral administration, and rapid onset of action. There are several concerns regarding potential harm, including an increased risk for hepatotoxicity, clinically significant bleeding, and acute coronary events. Therefore, additional trials and postmarketing surveillance will be needed. |
| format | Article |
| id | doaj-art-3021e2fae8d64ef184dd482593efeb33 |
| institution | Kabale University |
| issn | 2042-0056 |
| language | English |
| publishDate | 2011-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke Research and Treatment |
| spelling | doaj-art-3021e2fae8d64ef184dd482593efeb332025-02-03T01:28:13ZengWileyStroke Research and Treatment2042-00562011-01-01201110.4061/2011/607852607852Antithrombotic Medication for Cardioembolic Stroke PreventionM. Àngels Font0Jerzy Krupinski1Adrià Arboix2Institut d'Investigacions Biomèdiques de Bellvitge (IDIBELL), Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, 08907 Barcelona, SpainDepartment of Neurology, Cerebrovascular Diseases Unit, Hospital Universitari Mútua de Terrassa, Catalonia, 08227 Terrassa, SpainCerebrovascular Division, Department of Neurology, Hospital Universitari Sagrat Cor, University of Barcelona, C/Viladomat 288, Catalonia, 08029 Barcelona, SpainEmbolism of cardiac origin accounts for about 20% of ischemic strokes. Nonvalvular atrial fibrillation is the most frequent cause of cardioembolic stroke. Approximately 1% of population is affected by atrial fibrillation, and its prevalence is growing with ageing in the modern world. Strokes due to cardioembolism are in general severe and prone to early recurrence and have a higher long-term risk of recurrence and mortality. Despite its enormous preventive potential, continuous oral anticoagulation is prescribed for less than half of patients with atrial fibrillation who have risk factors for cardioembolism and no contraindications for anticoagulation. Available evidence does not support routine immediate anticoagulation of acute cardioembolic stroke. Anticoagulation therapy's associated risk of hemorrhage and monitoring requirements have encouraged the investigation of alternative therapies for individuals with atrial fibrillation. New anticoagulants being tested for prevention of stroke are low-molecular-weight heparins (LMWH), unfractionated heparin, factor Xa inhibitors, or direct thrombin inhibitors like dabigatran etexilate and rivaroxaban. The later exhibit stable pharmacokinetics obviating the need for coagulation monitoring or dose titration, and they lack clinically significant food or drug interaction. Moreover, they offer another potential that includes fixed dosing, oral administration, and rapid onset of action. There are several concerns regarding potential harm, including an increased risk for hepatotoxicity, clinically significant bleeding, and acute coronary events. Therefore, additional trials and postmarketing surveillance will be needed.http://dx.doi.org/10.4061/2011/607852 |
| spellingShingle | M. Àngels Font Jerzy Krupinski Adrià Arboix Antithrombotic Medication for Cardioembolic Stroke Prevention Stroke Research and Treatment |
| title | Antithrombotic Medication for Cardioembolic Stroke Prevention |
| title_full | Antithrombotic Medication for Cardioembolic Stroke Prevention |
| title_fullStr | Antithrombotic Medication for Cardioembolic Stroke Prevention |
| title_full_unstemmed | Antithrombotic Medication for Cardioembolic Stroke Prevention |
| title_short | Antithrombotic Medication for Cardioembolic Stroke Prevention |
| title_sort | antithrombotic medication for cardioembolic stroke prevention |
| url | http://dx.doi.org/10.4061/2011/607852 |
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