Successful intravenous thrombolysis of a wake-up stroke with underlying valvular atrial fibrillation
Background Atrial fibrillation is a major risk factor for ischaemic stroke. We investigated whether active screening for atrial fibrillation in secondary care, followed by careful evaluation of risk factors and communication to general practitioners from stroke specialists, could increase appropriate anticoagulation prescription.
Oral anticoagulation therapy has reduced the risk of ischaemic stroke and improved the outcomes for patients with atrial fibrillation considerably. The emergence of the non-vitamin K oral anticoagulants as alternatives to vitamin K antagonists has significantly changed the practice of stroke prevention in atrial fibrillation. As the main complication with antithrombotic therapy is bleeding, physicians should always balance the risk of ischaemic stroke against intracranial haemorrhage and intervene where appropriate to reduce both risks.
For the first time in 50 years new oral anticoagulants of proven efficacy and with acceptable safety profiles are available for patients with atrial fibrillation and venous thromboembolism. Here is a brief overview of the benefits and possible disadvantages of using these drugs.
KEYWORDS Dabigatran, rivaroxaban, apixaban, anticoagulation, atrial fibrillation, venous thromboembolism
DECLARATIONS OF INTERESTS No conflicts of interest declared.
Background: There are established differences in cardiovascular disease in different racial groups. Worldwide, the literature regarding the clinical epidemiology of atrial fibrillation (AF) in non-white populations is scarce.
Objectives: To document the clinical epidemiology of AF among hospital admissions to two teaching hospitals in Karachi, Pakistan, over a two-month period and to describe the clinical features and management of these patients.
Subjects: 3,766 acute medical admissions, of whom 245 (6.5%) had AF.