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Acute anticoagulation following cardioembolic stroke.
J F Rothrock1, H C Dittrich, S McAllen
1University of California, San Diego Stroke Center.
Stroke
|June 1, 1989
Summary
Acute anticoagulation for cardioembolic stroke appears safe, with low rates of hemorrhage and recurrent emboli. However, this early treatment did not demonstrate clear overall benefits for patients with cardioembolic stroke.
Area of Science:
- Neurology
- Cardiology
- Vascular Medicine
Background:
- Cardioembolic stroke presents a significant risk of early recurrence and hemorrhage.
- The optimal timing and safety of initiating anticoagulation in acute cardioembolic stroke remain debated.
Purpose of the Study:
- To evaluate the safety and efficacy of early anticoagulation in patients with acute cardioembolic stroke.
- To compare the incidence of hemorrhage and recurrent emboli in anticoagulated versus non-anticoagulated patients.
Main Methods:
- Retrospective analysis of 121 consecutive patients with acute cardioembolic stroke.
- Comparison of outcomes between 49 patients receiving therapeutic anticoagulation within 96 hours and 41 patients not receiving anticoagulants within the first 2 weeks.
Main Results:
- Both groups were comparable in age, sex, stroke severity, and cardiac disease spectrum.
- Clinically significant brain hemorrhage occurred in 2% of both anticoagulated and non-anticoagulated groups.
- Early recurrent embolization was also low, occurring in 2% of both groups.
Conclusions:
- Acute anticoagulation can likely be administered safely to most patients with cardioembolic stroke.
- Current data do not indicate a clear, significant benefit of early anticoagulation for the entire population of cardioembolic stroke patients.