Open AccessDifficult issues in the management of patients with atrial fibrillation: a neurologist's point of view
Author(s) -
А. А. Кулеш
Publication year - 2021
Publication title -
nevrologiâ, nejropsihiatriâ, psihosomatika
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.157
H-Index - 9
eISSN - 2310-1342
pISSN - 2074-2711
DOI - 10.14412/2074-2711-2021-5-4-13
Subject(s) - medicine , atrial fibrillation , stroke (engine) , intracerebral hemorrhage , microangiopathy , cardiology , intensive care medicine , clinical trial , ischemic stroke , ischemia , diabetes mellitus , subarachnoid hemorrhage , mechanical engineering , engineering , endocrinology
The article evaluates recent perspectives about the role of oral anticoagulants in the secondary prevention of cardioembolic stroke. The timing of prescribing drugs for ischemic stroke and transient ischemic attack is discussed in accordance with current clinical guidelines and the results of clinical trials. The issues of prescribing oral anticoagulants in some problematic situations, such as the elderly and senile age, reperfusion therapy, presence of hemorrhagic transformation, combined atherosclerosis of major head and neck arteries, cerebral microangiopathy, history of intracerebral hemorrhage, cryptogenic stroke, and low patient compliance are considered. Finally, an anticoagulant therapy algorithm in the acute period of cardioembolic stroke is presented.