[Risk factors of a new cardio-embolic cerebral accident in non-valvular atrial fibrillation treated with acenocoumarol].
OBJECTIVE
To investigate the risk factors determining the appearance of a new cardio-embolic cerebral accident on secondary thrombophylaxis of non-valvular auricular fibrillation (NVAF).


METHODS
Controlled observational study on a series of patients treated with acenocoumarol for a period of 2.8 years.


METHODS
Anticoagulation Unit of the La Paz Hospital and patients from Madrid Area 5.


METHODS
172 patients with NVAF, over 55 and with fibrillation for at least a year, and who had suffered at least one ischaemic cerebral accident. All were treated with acenocoumarol and controlled at an INR of 2.5. The risk factors were determined and the appearance of new cardio-embolic phenomena was watched during the study period.


RESULTS
12 cardio-embolic phenomena were recorded (11 CVA and one peripheral embolism). The univariate study showed there was a significant association between patients who suffered a new ictus and those who suffered heart failure (p < 0.05) and had a history of more than one ictus before the start of the study (p < 0.05). Multivariate analysis found that what had independent predictive value was having suffered more than one ictus.


CONCLUSIONS
The greatest threat for developing a new ischaemic CVA during anticoagulation in NVAF is having a history of two or more previous ictus, as if the tendency to recur was due to these patients having more extensive atherosclerosis.
Vázquez Muñoz
E
E
Area 5 y Hospital Universitario La Paz. Madrid. Especialista en Medicina Familiar y Comunitaria. envamu@mixmail.com
Gómez Cerezo
J
J
Fernández Pavón
A
A
D000074:Acenocoumarol / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications*; D005260:Female; D006801:Humans; D020766:Intracranial Embolism / Q000209:etiology* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000209:etiology* / Q000517:prevention & control*
D000925:Anticoagulants; D000074:Acenocoumarol