Antithrombotic Therapy in Cardiac Embolism

Overview

Journal Curr Cardiol Rev

Publisher Bentham Science Publishers

Specialty Cardiology & Vascular Diseases

Date 2011 Aug 2

PMID 21804782

Citations 1

Authors

Alvaro Cervera

Angel Chamorro

Affiliations

Soon will be listed here.

Abstract

Anticoagulation is indicated in most cardioembolic ischemic strokes for secondary prevention. In many cardiac conditions, anticoagulation is also indication for primary stroke prevention, mainly when associated to vascular risk factors. Anticoagulation should be started as soon as possible, as it is safe even in moderate acute strokes. The efficacy of early anticoagulation after cardioembolic stroke in relation to outcome has not been assessed adequately, but there is evidence from animal models and clinical studies that anticoagulation with unfractionated heparin is associated with a better outcome mediated in part by its anti-inflammatory properties.

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References

Meschengieser S, Fondevila C, Frontroth J, Santarelli M, Lazzari M . Low-intensity oral anticoagulation plus low-dose aspirin versus high-intensity oral anticoagulation alone: a randomized trial in patients with mechanical prosthetic heart valves. J Thorac Cardiovasc Surg. 1997; 113(5):910-6. DOI: 10.1016/S0022-5223(97)70264-2. View

Camerlingo M, Salvi P, Belloni G, Gamba T, Cesana B, Mamoli A . Intravenous heparin started within the first 3 hours after onset of symptoms as a treatment for acute nonlacunar hemispheric cerebral infarctions. Stroke. 2005; 36(11):2415-20. DOI: 10.1161/01.STR.0000185730.50480.e7. View

Eckman M, Rosand J, Knudsen K, Singer D, Greenberg S . Can patients be anticoagulated after intracerebral hemorrhage? A decision analysis. Stroke. 2003; 34(7):1710-6. DOI: 10.1161/01.STR.0000078311.18928.16. View

Mant J, Hobbs F, Fletcher K, Roalfe A, Fitzmaurice D, Lip G . Warfarin versus aspirin for stroke prevention in an elderly community population with atrial fibrillation (the Birmingham Atrial Fibrillation Treatment of the Aged Study, BAFTA): a randomised controlled trial. Lancet. 2007; 370(9586):493-503. DOI: 10.1016/S0140-6736(07)61233-1. View

Phan T, Koh M, Wijdicks E . Safety of discontinuation of anticoagulation in patients with intracranial hemorrhage at high thromboembolic risk. Arch Neurol. 2000; 57(12):1710-3. DOI: 10.1001/archneur.57.12.1710. View

Fuster V, Gersh B, GIULIANI E, Tajik A, BRANDENBURG R, Frye R . The natural history of idiopathic dilated cardiomyopathy. Am J Cardiol. 1981; 47(3):525-31. DOI: 10.1016/0002-9149(81)90534-8. View

Ryden L, Asinger R, Cannom D, Crijns H, Frye R, Halperin J . ACC/AHA/ESC Guidelines for the Management of Patients With Atrial Fibrillation: Executive Summary A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology.... Circulation. 2001; 104(17):2118-50. View

TYRRELL D, Horne A, Holme K, Preuss J, Page C . Heparin in inflammation: potential therapeutic applications beyond anticoagulation. Adv Pharmacol. 1999; 46:151-208. DOI: 10.1016/s1054-3589(08)60471-8. View

Dirnagl U, Iadecola C, Moskowitz M . Pathobiology of ischaemic stroke: an integrated view. Trends Neurosci. 1999; 22(9):391-7. DOI: 10.1016/s0166-2236(99)01401-0. View

10.

Futrell N, Millikan C . Frequency, etiology, and prevention of stroke in patients with systemic lupus erythematosus. Stroke. 1989; 20(5):583-91. DOI: 10.1161/01.str.20.5.583. View

11.

Steiner T, Rosand J, Diringer M . Intracerebral hemorrhage associated with oral anticoagulant therapy: current practices and unresolved questions. Stroke. 2005; 37(1):256-62. DOI: 10.1161/01.STR.0000196989.09900.f8. View

12.

Gage B, van Walraven C, Pearce L, Hart R, Koudstaal P, Boode B . Selecting patients with atrial fibrillation for anticoagulation: stroke risk stratification in patients taking aspirin. Circulation. 2004; 110(16):2287-92. DOI: 10.1161/01.CIR.0000145172.55640.93. View

13.

Bungard T, Ackman M, Ho G, Tsuyuki R . Adequacy of anticoagulation in patients with atrial fibrillation coming to a hospital. Pharmacotherapy. 2000; 20(9):1060-5. DOI: 10.1592/phco.20.13.1060.35038. View

14.

Albers G, Dalen J, Laupacis A, Manning W, Petersen P, Singer D . Antithrombotic therapy in atrial fibrillation. Chest. 2001; 119(1 Suppl):194S-206S. DOI: 10.1378/chest.119.1_suppl.194s. View

15.

Pessin M, Estol C, Lafranchise F, Caplan L . Safety of anticoagulation after hemorrhagic infarction. Neurology. 1993; 43(7):1298-303. DOI: 10.1212/wnl.43.7.1298. View

16.

Samsa G, Matchar D, Goldstein L, Bonito A, Lux L, WITTER D . Quality of anticoagulation management among patients with atrial fibrillation: results of a review of medical records from 2 communities. Arch Intern Med. 2000; 160(7):967-73. DOI: 10.1001/archinte.160.7.967. View

17.

Katz S, Marantz P, Biasucci L, Jondeau G, Lee K, Brennan C . Low incidence of stroke in ambulatory patients with heart failure: a prospective study. Am Heart J. 1993; 126(1):141-6. DOI: 10.1016/s0002-8703(07)80021-4. View

18.

Meissner I, Khandheria B, Heit J, Petty G, Sheps S, Schwartz G . Patent foramen ovale: innocent or guilty? Evidence from a prospective population-based study. J Am Coll Cardiol. 2006; 47(2):440-5. DOI: 10.1016/j.jacc.2005.10.044. View

19.

Singhal A, Topcuoglu M, Buonanno F . Acute ischemic stroke patterns in infective and nonbacterial thrombotic endocarditis: a diffusion-weighted magnetic resonance imaging study. Stroke. 2002; 33(5):1267-73. DOI: 10.1161/01.str.0000015029.91577.36. View

20.

Gage B . Can we rely on RE-LY?. N Engl J Med. 2009; 361(12):1200-2. DOI: 10.1056/NEJMe0906886. View