Prevention and treatment of ischemic stroke in patients with atrial fibrillation

Abstract

Introduction: Atrial fibrillation (AF) is a very frequent disease and it represents an important risk factor for stroke or any type of systemic embolism, which explains the high morbidity and mortality that occurs in this disease. Objectives: Evaluation of antiplatelet therapy in the prevention and in acute stroke, in patients with AF. Material and methods: The study included a number of 973 patients who were admitted to the Neurology Clinic during 01.01.2010-31.12.2010, with a diagnosis of acute stroke. The existent pathology was divided into ischaemic stroke (94.45%) and haemorrhagic stroke (5.55%). From the total number of ischaemic strokes, we only selected the patients with stroke and AF, with no carotid lesions detected with Doppler ultrasound. Patient evaluation included brain CT examination, carotid and vertebrobasilar Doppler ultrasound, electrocardiogram, heart ultrasound. Results: Among the patients with a first stroke, 48.17% did not follow any antithrombotic therapy, 44.51% had followed a certain type of therapy and we have no data about 7.31% of patients. Among the patients with a history of stroke, only 60.78% had followed a secondary prevention treatment. Therapy was established by assessing a risk level. Clinical outcome was favourable in 94.88% of cases and worsening occurred in 5.12% of cases. Conclusions: Most of the patients that had followed a primary prevention therapy did not follow any oral anticoagulant therapy because of various reasons. It is mandatory to use oral anticoagulant therapy in those patients with a risk high enough to cause stroke or recurrent stroke.