Revisión

Current management of antithrombotic treatment in patients with non valvular atrial fibrillation and prior history of stroke or transient ischemic attack

J. Masjuán, J. Álvarez-Sabín, M. Blanco, A. de Felipe, A. Gil-Núñez, J. Gállego-Culleré, J. Vivancos [REV NEUROL 2014;59:25-36] PMID: 24965928 DOI: https://doi.org/10.33588/rn.5901.2014037

OPEN ACCESS

Volumen 59 | Number 01 | Nº of views of the article 5.946 | Nº of PDF downloads 1.372 | Article publication date 01/07/2014

Download PDF Castellano Citation Search in PubMed

Share in:

Go to another issue

ABSTRACT

Atrial fibrillation is the most frequent arrhythmia seen in clinical practice and is one of the most important risk factors for suffering a stroke. Strokes associated to atrial fibrillation are more severe, present higher mortality and disability rates, and there is a greater risk of recurrence. Consequently, both primary and secondary prevention of stroke associated to atrial fibrillation by means of suitable antithrombotic treatment is clearly essential in order to lower this risk. Chronic oral anticoagulants are the cornerstone of antithrombotic treatment in patients with non-valvular atrial fibrillation, especially in those who have already had a stroke. Vitamin K antagonists have traditionally been used for this purpose. Yet, these drugs have several important disadvantages (narrow therapeutic window, unpredictable response, numerous interactions with drugs and foods, as well as starting and finishing their action slowly), which limit their use in clinical practice. The new oral anticoagulants not only overcome these disadvantages but also have proved to be at least as effective as warfarin in the prevention of strokes and systemic embolism in patients with non-valvular atrial fibrillation. Additionally, they have been shown to have a better safety profile, especially with an important drop in the risk of intracranial haemorrhage, regardless of the antecedents of stroke or transient ischaemic attack, which makes them first-choice drugs in the treatment of these patients. KeywordsAcenocumarol Apixaban Atrial fibrillation Dabigatran Edoxaban Rivaroxaban Stroke Transient ischaemic attack Vitamin K antagonists Warfarin CategoriesPatología vascular

FULL TEXT (solo disponible en lengua castellana / Only available in Spanish)

Acceso directo al último número

Último Podcast

Revisión

Current management of antithrombotic treatment in patients with non valvular atrial fibrillation and prior history of stroke or transient ischemic attack