[Prevention of cardioembolic stroke].
Stroke and atrial fibrillation (AF) constitute a true vascular epidemic with catastrophic consequences. The most common and devastating complication of AF is cardioembolic stroke but this catastrophic event can be predicted and prevented. Accurate etiologic diagnosis of stroke is essential for effective prevention. The percentage of cryptogenic ischemic strokes is too high and detection of AF and other causes of cardioembolic events should be improved. Cardioembolic cerebral ischemia can be prevented. However, because of physician inertia, lack of patient adherence and the problems of vitamin K antagonists, many patients are at risk of cerebral ischemia. Recently, major advances with drugs such as dronedarone, dabigatran and FXa inhibitors have opened the way to improving stroke prevention, as reflected in therapeutic guidelines, and neurologists should be familiar with these drugs. There is reason to hope that much suffering can be avoided.
Unidad de Ictus, Hospital General Universitario Gregorio Marañón, Madrid, Spain. agiln@meditex.es
Antonio
A
Gil Núñez
D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D001562:Benzimidazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D002545:Brain Ischemia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D000069604:Dabigatran; D004311:Double-Blind Method; D065427:Factor Xa Inhibitors; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use; D006331:Heart Diseases / Q000150:complications; D006470:Hemorrhage / Q000139:chemically induced / Q000517:prevention & control; D006801:Humans; D019934:International Normalized Ratio; D020766:Intracranial Embolism / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D015337:Multicenter Studies as Topic; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D016037:Single-Blind Method; D019851:Thrombophilia / Q000209:etiology; D014812:Vitamin K / Q000037:antagonists & inhibitors; D015091:beta-Alanine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use
D000925:Anticoagulants; D001562:Benzimidazoles; D065427:Factor Xa Inhibitors; D005343:Fibrinolytic Agents; D015091:beta-Alanine; D014812:Vitamin K; D000069604:Dabigatran