[Atrial fibrillation as a relevant risk factor for stroke].
Atrial fibrillation, one of the most frequent heart rhythm disturbances and the most common source of embolic material in cerebral circulation, is associated with a fivefold increased risk of ischemic stroke. Except thromboembolic complications, atrial fibrillation affects hemodynamic activity of the heart, reduces cardiac output and might decrease cerebral blood flow. It is possible that atrial fibrillation disturbs autoregulation mechanisms of cerebral circulation in patients suffering from an acute stroke. This could be the reason of higher early mortality and more severe clinical outcome versus strokes in patients with the sinus rhythm. An ongoing increase of population with atrial fibrillation is observed. Such patients often need intensive antithrombotic prevention with oral anticoagulants. Worldwide prescribing effective anticoagulant therapy is insufficient in relation to the needs. The leading reason underlying the under-utilization of oral anticoagulation in patients with atrial fibrillation is the lack of knowledge about importance of this kind of stroke prevention and fear of bleeding among doctors, particularly among general practitioners.
Porebska
Agata
A
Klinika Neurologii, Pomorska Akademia Medyczna. nowacprz@sci.pam.szczecin.pl
Nowacki
Przemysław
P
D001281:Atrial Fibrillation / Q000150:complications* / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D006801:Humans; D020521:Stroke / Q000209:etiology* / Q000503:physiopathology* / Q000517:prevention & control