Interní Med. 2012; 14(1): 26-29

Prevention of cardioembolic stroke

doc.MUDr.Jiří Bauer, CSc.

Neurologická klinika 1. LF UK a VFN, iktové centrum, Praha

Anticoagulant therapy plays an important role in primary and secondary prevention of brain embolism in patients with non-valvular

atrial fibrillation and other sources of cardioembolic strokes. The most commonly used anticoagulant in these indications is warfarin.

Warfarin significantly reduces the risk of stroke and death, but increases that of bleeding. Life-threatening intracerebral haemorrhage

is the most serious complication of anticoagulant therapy, with a mortality, that can exceed 50 %. New oral direct thrombin inhibitors

(dabigatran) and factor Xa inhibitors (rivaroxaban, apixaban) present promising alternatives to warfarin. Dabigatran etexilate is already

approved for prevention of ischaemic stroke in patients with atrial fibrillation at risk of stroke. Dabigatran is more effective than warfarin,

and has demonstrated a good safety profile.

Keywords: anticoagulant therapy, stroke, atrial fibrillation, warfarin, direct thrombin inhibitors, direct Xa factor inhibitors

Published: January 30, 2012  Show citation