Use of anticoagulants in cerebral vascular pathology

Abstract

The aetiology of ischemic vascular stroke (IVS) is various, the most common cause being cardioembolic, and anticoagulation treatment plays an essential role in the prevention of cerebral ischemic events. Atrial fibrillation (AF) is the pathological condition requiring long-term anticoagulant therapy for preventive purposes, both primary and secondary. Complications, disabilities and mortality are more common in patients who had an ischemic stroke associated with atrial fibrillation than in those without AF. The indication, type and dose of anticoagulant depend on the stage and size of the ischemic lesion, thromboembolic and haemorrhagic risk and patient compliance. According to the 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation, among the different types of anticoagulants indicated in the case of AF and IS, it would be preferable to use new anticoagulants. Anticoagulation medication is indicated in the acute stage only in patients with a clear thromboembolic source. Anticoagulant treatment has a well-established role over time as a result of numerous clinical trials, its use having a guide recommendation, but the particularity of each case as well as personal experience strengthens the indication.