Cardioembolic stroke: risk factors, forecast, secondary prevention

Abstract

The goal of the study is to evaluate the effectiveness of warfarin and the new direct anticoagulants (xarelto and pradaxa) in the secondary prevention of re-occurrence of cardioembolic stroke (CES). Material and methods. Inclusion criteria of patients in the study: migrated CES, confirmed the presence of a pathology of heart; reception of indirect anticoagulant (warfarin) or direct inhibitors of factor Xa (xarelto, pradaxa) to prevent re-CES. Exclusion criteria from the study: patients with other subtypes of ischemic stroke (IS), hemorrhagic stroke (HS), patients receiving aspirin, diseased patients with CES. The severity of neurological deficit was assessed according to the NIHSS, Rivermead, Rankine and Barthel scales. Results. By the end of the second year of monitoring after suffering CES number of patients with full recovery a self-service increased by 3% and decreased by the same number of patients with moderate and severe dependence on assistance in everyday life. More efficient and faster neurological function was restored in patients taking warfarin is worse in the group of patients receiving pradaxa. However, a second stroke in the first year after suffering several CES were more frequent in the group of patients receiving pradaxa, and usually fatal. Conclusion. Change of medications in the group of patients receiving xarelto and warfarin, other anticoagulants have not led to the emergence of recurrent stroke.

Keywords

• cardioembolic stroke
• direct and indirect anticoagulants
• pradaxa
• warfarin
• xarelto