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Synapse
September 21, 2010Age and Ageing9 citationsOpen Access

Anticoagulation for atrial fibrillation: should warfarin be temporarily stopped or continued after acute cardioembolic stroke?

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PMP MuddMJMartin James

Structured PICO

Should warfarin be temporarily stopped, continued, or reversed after an acute cardioembolic stroke in patients with atrial fibrillation?

P
Population
Patients with atrial fibrillation who suffer an acute cardioembolic stroke despite anticoagulation.
I
Intervention
Temporary cessation, continuation, or reversal of warfarin.
C
Comparator
Alternative anticoagulation management strategies (e.g., stopping vs. continuing warfarin).
O
Outcome
Risks and benefits of each treatment strategy, including haemorrhagic transformation of the infarct.

This review highlights the clinical uncertainty and need for further research regarding the optimal management of warfarin following an acute cardioembolic stroke in patients with atrial fibrillation.

Abstract

Despite anticoagulation for atrial fibrillation, some patients still suffer an ischaemic stroke. The issue of whether to stop or continue warfarin, or possibly to reverse the anticoagulation is an area of uncertainty. Continued anticoagulation may, however, increase haemorrhagic transformation of the infarct. In this article we review the published evidence in an attempt to quantify the risks and benefits of each treatment strategy and identify areas for further research.

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Cite This Study

Mudd et al. (2010) studied this question.

synapsesocial.com/papers/6a8262af2beaf6c72d8783b2https://doi.org/10.1093/ageing/afq110
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Stroke prevention in atrial fibrillation1997 · 13 citations
  2. 2Anticoagulation for prevention of stroke1998 · 24 citations
  3. 3Acute anticoagulation adjustment in patients with atrial fibrillation at risk for stroke: approaches, strategies, risks and benefits2005 · 2 citations
  4. 4Antithrombotic Medication for Cardioembolic Stroke Prevention2011 · 20 citations
  5. 5Stroke prevention in nonvalvular atrial fibrillation: A review of prospective randomized trials1991 · 102 citations