A benefit/risk analysis of the prevention of brain ischaemia with anticoagulant drugs: when, how and whom to treat?
This paper summarises the benefits and risks of anticoagulant treatment in patients who have had cerebral ischaemia. In patients with a cardiac source of embolism (in most studies atrial fibrillation), anticoagulation with a target intensity of an INR of 2.0--3.0 is the therapy of first choice. In the case of a contraindication to such treatment, aspirin and ibuprofen are safe, but less effective alternatives. In patients with cerebral ischaemia of presumed arterial origin, anticoagulation with an achieved intensity of 3.0--4.5 proved not to be safe. Results from trials with more moderate anticoagulation regimes are awaited.
Algra
A
A
University Department of Neurology and Julius Center for Patient Oriented Research, University Medical Center Utrecht, Utrecht, The Netherlands. A.Algra@neuro.azu.nl
D000925:Anticoagulants / Q000627:therapeutic use*; D002545:Brain Ischemia / Q000188:drug therapy* / Q000517:prevention & control*; D006801:Humans; D018570:Risk Assessment
D000925:Anticoagulants