Key result
Anticoagulation with a target INR of 2.0-3.0 is the therapy of first choice for patients with cerebral ischaemia from a cardiac source, while higher intensity (INR 3.0-4.5) for arterial origin is unsafe.
Why the study?
Does anticoagulant treatment safely prevent recurrent brain ischaemia in patients with prior cerebral ischaemia?
Does anticoagulant treatment safely prevent recurrent brain ischaemia in patients with prior cerebral ischaemia?
Anticoagulation with INR 2.0-3.0 is recommended for secondary prevention of stroke in patients with a cardiac source of embolism, whereas high-intensity anticoagulation is unsafe for arterial-origin ischaemia.
Supports moderate-intensity anticoagulation for cardiac-source ischaemia; leaves open optimal regimens for arterial-origin cases.
This paper summarises the benefits and risks of anticoagulant treatment in patients who have had cerebral ischaemia. In patients with a cardiac source of embolism (in most studies atrial fibrillation), anticoagulation with a target intensity of an INR of 2.0--3.0 is the therapy of first choice. In the case of a contraindication to such treatment, aspirin and ibuprofen are safe, but less effective alternatives. In patients with cerebral ischaemia of presumed arterial origin, anticoagulation with an achieved intensity of 3.0--4.5 proved not to be safe. Results from trials with more moderate anticoagulation regimes are awaited.
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Ale Algra (2001) conducted a review in Cerebral ischaemia. Anticoagulant treatment vs. Aspirin and ibuprofen was evaluated. Anticoagulation with a target INR of 2.0-3.0 is the therapy of first choice for patients with cerebral ischaemia from a cardiac source, while higher intensity (INR 3.0-4.5) for arterial origin is unsafe.
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