How well Do We Prevent Cardioembolic Stroke?

J Korean Neurol Assoc > Volume 14(1); 1996 > Article

Journal of the Korean Neurological Association 1996;14(1): 1-8.

심인성 뇌색전 환자에 있어서의 일차적 또는 이차적 뇌졸중 예방실태

윤병우, 김병건, 노재규

서울대학교 의과대학 신경과학교실

How well Do We Prevent Cardioembolic Stroke?

Byung-Woo Yoon,M.D., Byoung-Kon Kim,M.D., Jae-Kyu Roh,M.D.

Department of Neurology, College of Medicine, Seoul National University

Abstract

Background & Objectives : Recent studies suggest that anticoagulation, or antiplatelet therapy is safe and effective for the prevention of cardiogenic embolic stroke. However it has not been studied in Korea how the patients with cardioembolic source were managed in practice for the prevention of stroke. This study was done to assess the current status of primary and secondary prevention of cardioembolic stroke. Methods : Retrospective study was undertaken in 124 patients with cardiogenic embolic stroke, following items were examined, previous anticoagulation or antiplatelet therapy, previous stroke, Insight of the heart disease, and International Normalize Ratio(INR) value on arrival at the hospital. Results : In 124 patients cardioembolic sources were constituted of non-valvular atrial fibrillation (NVAF) in 54, rheumatic heart disease In 40, prosthetic cardiac valve In 14, dilated cardiomyopathy(D-CMP) in 6, left ventricular akinetic segment in 7(including 3 cases of LV thrombi), recent myocardial infarction in 3. In 93 patients with no previous stroke, 44 patients had regular medical follow-up because of his/her cardiac problems and primary prevention of stroke was made only in 12 (27%) patients (8 on anticoagulation and 4 on antiplatelet therapy) . The rate of primary prevention varied according to the type of cardioembolic source; 100% with mechanical prosthetic valve, 33.3% with valvular atrial fibrillation, 6.7% with NVAF, and none with D-CMP and bioprosthetic valve. Previous stroke was found in 31 patients, among whom 24 had been followed regularly. Twenty patients(83%) were under secondary prevention of cardioembolic stroke (anticoagulation in 11 and antiplatelet agents in 9) . Among 19 patients who developed stroke in spite of anticoagulation, INR values were lower than 1.5 in 12(63%), between 1.5 and 2.0 in 5(26%), and above 2.0 in 2(11%). Conclusion : Our results suggest that cardioembolic strokes have not been prevented properly. Many physicians seem to be reluctant to anticoagulate their patients with cardioembolic source, and even with anticoaguation the dosage is frequently insufficient to prevent stroke.

TOOLS

PDF Links
Full text via DOI
Download Citation
Share :

METRICS

1,340 View
7 Download

Related articles

Editorial Office: (ZIP 03163) #1111, Daeil Bldg, 12, Insadong-gil, Jongno-gu, Seoul, Korea
Tel: +82-2-737-6530 Fax: +82-2-737-6531 E-mail: jkna@neuro.or.kr

Copyright © 2024 by Korean Neurological Association.