[Oral anticoagulation in the secondary prevention of cerebrovascular disease. Long-term follow-up of 169 patients].
BACKGROUND
Although the indications for oral anticoagulation (AO) in the treatment of cerebral vascular disease (CVD) are well established, their potential side effects continue to give cause for worry.


OBJECTIVE
To describe the complications and ischemic relapses in patients treated with AO for secondary prevention of CVD of cardiac embolic origin.


METHODS
We included 169 patients with embologenic cardiopathy who, following an CVD, were treated with AO and followed-up at our medical centre for at least three months. We recorded their past clinical history and risk factors, occurrence of vascular relapses (VR), complications involving hemorrhage (CH), and data regarding course and follow-up.


RESULTS
During an average follow-up of 50.3 months of a total of 707.9 patient/years, 20 VR (2.8% per year) were recorded; 15 of these were cerebro-vascular and mainly mild. We recorded 59 CH in 41 patients (8.3% per year) of which 6 were considered to be major. There was a 30% drop-out rate from follow-up at our centre, mainly due to death from other causes or to change of referral centre.


CONCLUSIONS
There is a low incidence of relapse and of complications (usually mild) following AO for the secondary prevention of CVD of cardio-embolic origin. Efficacy and security are maintained in the long term.
Palomeras
E
E
Servicio de Neurología, Hospital del Mar, Barcelona, España.
Roquer
J
J
Pou
A
A
D000074:Acenocoumarol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000284:Administration, Oral; D000437:Alcoholism / Q000453:epidemiology; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001161:Arteriosclerosis / Q000453:epidemiology; D001281:Atrial Fibrillation / Q000150:complications; D002311:Cardiomyopathy, Dilated / Q000150:complications; D015331:Cohort Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000150:complications; D006470:Hemorrhage / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D002542:Intracranial Embolism and Thrombosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D015993:Life Tables; D009203:Myocardial Infarction / Q000150:complications; D012008:Recurrence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome
D000925:Anticoagulants; D000074:Acenocoumarol
Anticoagulación oral en la prevención secundaria de la enfermedad vascular cerebral. Seguimiento a largo plazo de 169 pacientes.