STROKE-ANTICOAGULANT THERAPY
SUMMARY
1. Immediate anticoagulant therapy in patients with acute ischemic stroke is not associated with any significant net short- or long-term benefit.
2. Best reason to anticoagulate for cardiac sources of emboli: non-valvular AF & mural thrombus from MI[1].
3. Among patients with non-valvular AF, anticoagulation can reduce stroke by 60%[2].
4. Agents used: Warfarin (inhibits Vit K-dependent coagulation factors, for valvular & non-valvular AF); Dabigatran (direct thrombin inhibitor, for non-valvular AF); Rivaroxaban & Apixaban (factor Xa inhibitors, for non-valvular AF).
Reference(s)
- ↑ McBride, R. and Stroke Prevention in Atrial Fibrillation Investigators, 1991. Stroke prevention in atrial fibrillation study. Final results. Circulation (New York, NY), 84(2), pp.527-539.
- ↑ Hart, R.G., Pearce, L.A. and Aguilar, M.I., 2007. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Annals of internal medicine, 146(12), pp.857-867.
Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].
