Korean J Stroke.
2012 Dec;14(3):106-115.
Focused Update on Primary Stroke Prevention in Patients with Atrial Fibrillation in Korean Clinical Practice Guidelines for Stroke
- Affiliations
-
- 1Department of Neurology, Eulji University College of Medicine, Daejeon, Korea.
- 2Department of Neurology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
- 3Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
- 4Department of Neurology, Konkuk University College of Medicine, Seoul, Korea.
- 5Department of Neurology, Hallym University College of Medicine, Anyang, Korea.
- 6Department of Neurology, Inha University College of Medicine, Incheon, Korea.
- 7Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
- 8Department of Neurology, University of Ulsan College of Medicine, Seoul, Korea.
- 9Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
- 10Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
- 11Department of Neurology, Catholic University College of Medicine, Seoul, Korea. nrkoomh@chol.com
Abstract
- Pivotal clinical trials testing the efficacy of new antithrombotics for the prevention of stroke and systemic embolism in patients with atrial fibrillation have been published since the release of the first edition of Korean clinical practice guidelines for primary stroke prevention. From July 2007 to August 2012, 5 clinical studies and update of guidelines in Europe and North America were identified through systematic search. In patients with atrial fibrillation who were unsuitable for warfarin, the combination of clopidogrel and aspirin reduced the risk of stroke at the cost of increased major bleedings as compared to aspirin. In patients with nonvalvular atrial fibrillation and risk factors for stroke, new oral anticoagulants, dabigatran, rivaroxaban and apixaban, were as effective as or more effective than warfarin in preventing stroke or systemic embolism. The risks of major bleeding with novel anticoagulants were similar to or lower than that of warfarin. Particularly, the risk of intracranial bleeding was significantly lower with novel anticoagulants than with warfarin. In this report, we summarized the new evidences and updated our recommendations for primary stroke prevention in patients with atrial fibrillation.
MeSH Terms
-
Anticoagulants
Aspirin
Atrial Fibrillation
Benzimidazoles
beta-Alanine
Embolism
Europe
Hemorrhage
Humans
Morpholines
North America
Primary Prevention
Pyrazoles
Pyridones
Risk Factors
Stroke
Thiophenes
Ticlopidine
Warfarin
Dabigatran
Rivaroxaban
Anticoagulants
Aspirin
Benzimidazoles
Morpholines
Pyrazoles
Pyridones
Thiophenes
Ticlopidine
Warfarin
beta-Alanine
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- The Primary Goal of Anticoagulation in Atrial Fibrillation to Prevent Stroke and Not to Offer the Apparently Cheapest Treatment
- The Mechanism of and Preventive Therapy for Stroke in Patients with Atrial Fibrillation
- Practical Issues to Prevent Stroke Associated with Non-valvular Atrial Fibrillation
- How and When to Screen for Atrial Fibrillation after Stroke: Insights from Insertable Cardiac Monitoring Devices
- Prevention of stroke in atrial fibrillation
