Key result
Early initiation of anticoagulation in two patients with acute cardio-embolic stroke and cardiac thrombi resulted in good clinical and neurological outcomes without hemorrhagic complications.
Why the study?
While anticoagulation is accepted for cardio-embolic ischemic events, the optimal timing of when to initiate anticoagulation remains an unresolved dilemma.
Does early initiation of anticoagulation improve clinical outcomes and prevent recurrent thromboembolism without causing hemorrhagic complications in patients with acute cardio-embolic stroke and cardiac thrombi?
Case Report (n=2)
No
Does early initiation of anticoagulation improve clinical outcomes and prevent recurrent thromboembolism without causing hemorrhagic complications in patients with acute cardio-embolic stroke and cardiac thrombi?
Early initiation of anticoagulation in acute cardio-embolic stroke with cardiac thrombi may be safe and effective, though individualized risk-benefit assessment is required.
May support early anticoagulation in select cardioembolic stroke cases; hypothesis-generating and requires prospective validation.
Ischemic stroke has been one of the major reason for morbidity and mortality all over the world. Anticoagulation treatment in patients with cerebral ischemic events caused by cardiac emboli is no longer a matter of debate. The problem is when to start. Because of a recurrence rate of 15 to 20% in the first few weeks after the initial event, direct anticoagulation by means of intravenous heparin followed by oral anticoagulants seems to be indicated. We are presenting 2 cases of patients who suffered cardio-embolic stroke due to cardiac thrombosis and had a therapeutic dilemma on when to start the anticoagulation treatment. Early anticoagulation treatment was associated with good clinical and neurological outcome.
No takes yet. Share an insight, caveat, or question.
Shil et al. (2021) conducted a case report in Acute ischemic stroke with cardiac thrombi (n=2). Early anticoagulation was evaluated on Clinical outcome and hemorrhagic complications. Early initiation of anticoagulation in two patients with acute cardio-embolic stroke and cardiac thrombi resulted in good clinical and neurological outcomes without hemorrhagic complications.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: