Antikoagulation vid akut stroke med förmaksflimmer. Fem frågor bör besvaras innan behandlingen kan anses
vara evidensbaserad
Engelsk titel: Anticoagulation in acute stroke with atrial fibrillation. Five questions should be answered before the treatment
can be considered evidence-based
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Författare:
Terent, Andreas
;
Åsberg, Signild
;
Hijazi, Ziad
Email: andreas.terent@medsci.uu.se
Språk: Swe
Antal referenser: 20
Dokumenttyp:
Artikel
UI-nummer: 14067951
Sammanfattning
The use of oral anticoagulants (OACs) is increasing rapidly among patients with acute ischemic stroke and atrial fibrillation (AF) in Sweden. The mean age in this patient category is high, 80 years on an average. The long-term risk of bleeding, intracranial or gastrointestinal in particular, among patients treated with OACs increases significantly above 75 years of age. Hemorrhagic transformation (HT) of embolic cerebral infarcts is common within the first week after onset of symptoms. Many questions remain to be answered before acute treatment with OACs could be recommended to the absolute majority of patients with ischemic stroke and AF. What is the risk for a new stroke if treatment with OACs is delayed? How risky is it to start OAC treatment in patients with HT? Are there prognostic scores under development for patients with acute ischemic stroke and AF?