Related Experiment Video
Updated: Sep 30, 2025

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
[Modern strategies of antithrombotic therapy in patients with multifocal atherosclerosis]
S S Kucherenko1,2, T M Alekseeva2
1Sokolov North-Western District Scientific and Clinical Center, St. Petersburg, Russia.
Insights
Selecting antithrombotic therapy is crucial for multifocal atherosclerosis patients, especially those with cerebrovascular disease. Combination therapy with aspirin and rivaroxaban shows promise in preventing noncardioembolic stroke.
Area of Science:
- Cardiology
- Neurology
- Vascular Medicine
Background:
- Multifocal atherosclerosis poses significant risks, with cerebrovascular pathology being a leading cause of mortality and disability.
- Understanding the etiology, pathogenesis, and pathogenetic subtypes of ischemic stroke is critical for effective management.
- Antithrombotic therapy plays a vital role in preventing noncardioembolic stroke.
Purpose of the Study:
- To analyze modern antithrombotic therapy strategies for patients with multifocal atherosclerosis.
- To evaluate evidence-based medicine data from randomized trials on antithrombotic treatments.
- To present new findings on combination therapy for stroke prevention.
Main Methods:
- Review of evidence-based medicine data.
- Analysis of results from randomized clinical trials.
- Comparative analysis of clinical trial outcomes.
Main Results:
- Demonstration of modern antithrombotic therapy strategies based on randomized trials.
- Analysis of pathogenetic subtypes of ischemic stroke and diagnostic criteria.
- Highlighting the benefits of combination therapy with acetylsalicylic acid (100 mg/day) and rivaroxaban (2.5 mg twice daily) as shown in the COMPASS study.
Conclusions:
- Antithrombotic therapy selection is key in managing multifocal atherosclerosis.
- Combination therapy with low-dose aspirin and rivaroxaban offers significant benefits in preventing noncardioembolic stroke.
- Evidence supports modern antithrombotic strategies, including combination therapy, for improved patient outcomes.
Abstract:
The manuscript is devoted to the problem of selection of antithrombotic therapy in the management of patients with multifocal atherosclerosis. The leading role of cerebrovascular pathology in the structure of mortality and causes of disability is noted. The questions of etiology and pathogenesis of acute cerebrovascular accident are considered. The pathogenetic subtypes of ischemic stroke and the criteria for their diagnosis were analyzed. The important role of antithrombotic therapy in the prevention of noncardioembolic stroke is presented. Considering the evidence-based medicine data based on the analysis of randomized trials results, modern strategies of antithrombotic therapy were demonstrated. A comparative analysis of the clinical trials results was carried out. New ideas about the benefits of combination therapy with acetylsalicylic acid at a dose of 100 mg/day and with rivaroxaban 2.5 mg twice daily, established in the COMPASS study, are presented.
Related Concept Videos
Atherosclerosis III: Management
Venous Thrombosis III: Interprofessional Care
Atherosclerosis IV: Nursing Management
Peripheral Artery Disease III: Interprofessional Care
Angina IV: Management
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...

