Open AccessManagement of acute stroke in patients taking novel oral anticoagulants
Author(s) -
Hankey Graeme J.,
Norrving Bo,
Hacke Werner,
Steiner Thorsten
Publication year - 2014
Publication title -
international journal of stroke
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.375
H-Index - 74
eISSN - 1747-4949
pISSN - 1747-4930
DOI - 10.1111/ijs.12295
Subject(s) - medicine , rivaroxaban , dabigatran , apixaban , atrial fibrillation , thrombolysis , stroke (engine) , edoxaban , ischemic stroke , intensive care medicine , acute stroke , intracranial bleeding , cardiology , warfarin , ischemia , tissue plasminogen activator , myocardial infarction , mechanical engineering , engineering
Each year, 1·0–2·0% of individuals with atrial fibrillation and 0·1–0·2% of those with venous thromboembolism who are receiving one of the novel oral anticoagulants (dabigatran, rivaroxaban, or apixaban) can be expected to experience an acute ischemic stroke. Additionally, 0·2–0·5% of individuals with atrial fibrillation who are receiving one of the novel oral anticoagulants can be expected to experience an intracranial hemorrhage. This opinion piece addresses the current literature and offers practical approaches to the management of patients receiving novel oral anticoagulants who present with an ischemic or hemorrhagic stroke. Specifically, we discuss the role of thrombolysis in anticoagulated patients with acute ischemic stroke and factors to consider concerning restarting anticoagulation after acute ischemic and hemorrhagic stroke.