The Opportunities for Risk Reduction of Recurrent Stroke in Atrial Fibrillation

Aim. To study adherence to guidelines of patients’ management in atrial fibrillation (AF) in the spotlight of recurrent stroke risk reduction. Material and methods. Totally 350 patients (227 women, 123 men) included with AF of non-valvular etiology, with anamnesis of cardioembolic stroke (CES) in carotid pool. Patients were selected into 3 groups according to the parameters of NIHSS stroke severity. A complex clinical and instrumental study was performed at the baseline, in 3, 6 months and 1 year of follow-up, including hemostasis assessment. Results. In 28% AF was found first time during the stroke acute phase; in 109 (31,1%) patients — paroxysmal AF. Before the inclusion anticoagulants took 23 patients (6,9%), 8 (2,4%) took NOAC. The highest part of persons with the high risk of bleeding by HAS-BLED was marked in the III group — 27 cases (34,6%). In 3 month 6 patients died (1,7%): mean age 74,3±1,34 y., NOAC received only 2 patients. In 3 months in the group of the diseased (n=51) taking apixaban, a significant (pp<0,05) improvement marked, of the clotting parameters: decrease of fibrinogen level, stabilization of APTT. Conclusion. Conduction of further follow-up would define relevant markers of clotting pathology, making to forecast an adverse outcome in early rehabilitation period in AF, having CES and high comorbidity index.