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Heart-brain relationship: atrial fibrillation and stroke
Natan Bornstein1, Francesco Corea, Virgilio Galllai
1Dep Neurology, University Hospital, Tel Aviv, Israel.
Clinical and Experimental Hypertension (New York, N.Y. : 1993)
|November 27, 2002
Summary
Stroke is a leading cause of death and disability in Western countries. Anticoagulation and aspirin effectively reduce stroke risk in nonvalvular atrial fibrillation (NVAF) patients, yet many eligible individuals remain undertreated.
Area of Science:
- Cardiology
- Neurology
- Public Health
Background:
- Stroke is a major cause of death and disability globally.
- Cardiogenic embolism is a primary cause of recurrent strokes.
- Nonvalvular atrial fibrillation (NVAF) is the most common source of cardiogenic embolism, leading to a significant annual stroke recurrence rate.
Purpose of the Study:
- To highlight the significant impact of stroke as a cause of death and disability.
- To emphasize the role of nonvalvular atrial fibrillation (NVAF) in cardiogenic embolism and stroke recurrence.
- To advocate for increased anticoagulation treatment in NVAF patients for stroke prevention.
Main Methods:
- Review of randomized trials on anticoagulation and aspirin in NVAF patients.
- Analysis of stroke risk reduction associated with these treatments.
- Assessment of undertreatment rates among eligible NVAF patients.
Main Results:
- Anticoagulation demonstrates a 70% stroke risk reduction in NVAF.
- Aspirin offers a 22% stroke risk reduction in NVAF.
- A significant gap exists in the appropriate treatment of NVAF for stroke prevention.
Conclusions:
- Anticoagulation and aspirin are proven safe and effective for stroke prevention in NVAF.
- Increased efforts are crucial to improve treatment rates for primary and secondary stroke prevention in NVAF.
- Addressing undertreatment is essential for effective public health strategies against stroke.