Медицинский совет (Dec 2013)
Prognosis and prevention of cardioembolic stroke in patients with atrial fibrillation
Abstract
The article is a review of literature on the prognosis and prevention of stroke in patients with atrial fibrillation (AF). It is noted that the simple CHA2DS2-VASc calculator is a good predictor of the risk of stroke in AF. Oral anticoagulants are recommended to patients with one or more risk factors for stroke according to CHA2DS2-VASc. There is data from large randomized trials showing that new oral anticoagulants (dabigatran, rivaroxaban, apixaban) can be as good as or better than warfarin in significantly reducing the risk of stroke, and are associated with lower risk of serious, particularly intracranial, bleeding. Positive experience related to the use of dabigatran (Pradaxa®), in a dose of 150 mg or 110 mg twice in patients with AF, is described. The introduction of new anticoagulants into the national neurological practice which do not require international normalized ratio control, will ensure wider use of anticoagulant therapy in patients with AF and reduce the incidence of cardioembolic stroke.
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