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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...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE-Hindawi Access to Research
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3148601/ https://www.ncbi.nlm.nih.gov/pubmed/21822469 http://dx.doi.org/10.4061/2011/607852 |
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author | Font, M. Àngels Krupinski, Jerzy Arboix, Adrià |
author_facet | Font, M. Àngels Krupinski, Jerzy Arboix, Adrià |
author_sort | Font, M. Àngels |
collection | PubMed |
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 | Online Article Text |
id | pubmed-3148601 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | SAGE-Hindawi Access to Research |
record_format | MEDLINE/PubMed |
spelling | pubmed-31486012011-08-05 Antithrombotic Medication for Cardioembolic Stroke Prevention Font, M. Àngels Krupinski, Jerzy Arboix, Adrià Stroke Res Treat Review Article 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. SAGE-Hindawi Access to Research 2011-06-22 /pmc/articles/PMC3148601/ /pubmed/21822469 http://dx.doi.org/10.4061/2011/607852 Text en Copyright © 2011 M. Àngels Font et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Article Font, M. Àngels Krupinski, Jerzy Arboix, Adrià Antithrombotic Medication for Cardioembolic Stroke Prevention |
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 |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3148601/ https://www.ncbi.nlm.nih.gov/pubmed/21822469 http://dx.doi.org/10.4061/2011/607852 |
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