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Thromboembolism in atrial fibrillation.
Jan Menke1, Lars Lüthje, Andreas Kastrup
1University Hospital, Göttingen, Germany. menke-j@t-online.de
The American Journal of Cardiology
|February 16, 2010
Summary
Atrial fibrillation significantly increases the risk of thromboembolism, including stroke and limb ischemia. Guideline-adherent antithrombotic therapy with aspirin or warfarin effectively reduces these risks.
Area of Science:
- Cardiology
- Vascular Medicine
- Thrombosis Research
Background:
- Atrial fibrillation is a major risk factor for systemic thromboembolism.
- Thromboembolic events in atrial fibrillation include stroke, mesenteric ischemia, and limb ischemia.
Purpose of the Study:
- To provide an overview of thromboembolic disease as a complication of atrial fibrillation.
- To review current and emerging therapeutic strategies for risk reduction.
Main Methods:
- Systematic literature search of PubMed, Embase, and Cochrane databases (1986-2009).
- Extraction of data from 10 evidence-based guidelines and 61 additional sources.
Main Results:
- Atrial fibrillation increases annual stroke risk by 2.3% (30% lethality).
- Annual incidence of acute mesenteric ischemia is 0.14% (70% lethality), and acute limb ischemia is 0.4% (16% lethality).
- Stroke accounts for approximately 80% of embolism-related deaths.
Conclusions:
- Atrial fibrillation predisposes patients to significant thromboembolic risks.
- Early diagnosis and guideline-adherent antithrombotic therapy (aspirin, warfarin) are crucial for risk reduction.
- Novel anticoagulants and self-monitoring of international normalized ratio (INR) represent future therapeutic directions.
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