Challenges of antithrombotic treatment after embolic stroke- case presentation

• Main Authors: Ioana Stanescu, Gabriela Dogaru
• Format: Article
• Language: English
• Published: Romanian Association of Balneology, Editura Balneara 2017-05-01
• Series: Balneo Research Journal
• Subjects: atrial fibrillation; embolic stroke; anticoagulant treatment
• Online Access: http://bioclima.ro/Balneo143.pdf

Atrial fibrillation (AF) represents one of the most common preventable causes of stroke, conferring a fivefold increased risk of stroke. The risk of stroke caused by AF is underestimated, many AF episodes being asymptomatic. Embolic strokes caused by AF can be prevented using anticoagulant therapy. The ESC (European Society of Cardiology) guidelines for patients with AF recommend anticoagulant therapy if the risk for embolic stroke / systemic embolism, evaluated with the CHA2DS2-VASc score, is high. Bleeding is the major complication of anticoagulant therapy. For every patient taking anticoagulant medication, HAS-BLED score assessing the risk of bleeding needs to be performed. The priorities in treating patients with atrial fibrillation are protection against embolic events and minimal risk of hemorrhagic events. Vitamin K antagonists, despite their accessibility and long term use, have important limitations. New/direct oral anticoagulants are better options, with alt least identical efficacy and higher safety profile. In real life, the choice of the appropriate anticoagulant agent could be challenging.