Document Detail

Anticoagulation in patients with acute ischemic stroke and atrial fibrillation--a balance of risks and benefits.
MedLine Citation:
PMID:  18642133     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We reviewed the current literature regarding anticoagulation in patients presenting with acute ischemic stroke and atrial fibrillation. METHODS: A systematic literature search was performed using PUBMED. All relevant articles including meta-analysis, original case studies and cross-references from relevant articles were included in this review. RESULTS: Atrial fibrillation is a thrombogenic state and predisposes to acute embolic strokes. Most studies do not show any mortality or morbidity benefit of anticoagulation with unfractionated or low-molecular weight heparins in patients with acute stroke. The relative risk of hemorrhagic transformation of the ischemic stroke is higher than the lowering of stroke due to recurrent embolism. Large infarcts, greater patient age, extensive small vessel disease and uncontrolled hypertension should prompt a further delay in anti-coagulation. CONCLUSION: Avoid anticoagulation with heparins in patients with acute ischemic stroke with atrial fibrillation for 7-10 days. Further studies are needed to delineate when to start oral anticoagulation.
Abhimanyu Beri; Sujeeth Reddy Punnam
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Publication Detail:
Type:  Journal Article; Review     Date:  2008-07-21
Journal Detail:
Title:  Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy     Volume:  22     ISSN:  0920-3206     ISO Abbreviation:  Cardiovasc Drugs Ther     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-05     Completed Date:  2009-01-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8712220     Medline TA:  Cardiovasc Drugs Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  419-25     Citation Subset:  IM    
Department of Internal Medicine, Michigan State University, 3140 Staten Ave Apt 5, Lansing, MI 48910, USA.
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MeSH Terms
Administration, Oral
Anticoagulants / administration & dosage,  adverse effects,  therapeutic use*
Atrial Fibrillation / complications*
Brain Ischemia / complications*
Risk Assessment
Risk Factors
Stroke / drug therapy*,  etiology
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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