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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
PubMed

Insights

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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