Medical Management of Persons at Risk for Cardioembolic Stroke

pp 497-500

Abstract

Several clinical trials of therapies in persons with atrial fibrillation have established the usefulness of oral anticoagulants or aspirin in prevention of cardioembolic stroke. Most persons with cardiac diseases associated with a high risk for embolismare now chronically treated with oral anticoagulants. Aspirin is an alternative therapy for persons who can not receive anticoagulants and can be an adjunctive therapy for persons who have ischemic symptoms despite anticoagulant treatment. Anti-platelet aggregation drugs may be useful for per-sons who have low-risk cardiac diseases. The optimal acute management of persons with cardioembolic stroke has not been established. Heparin is frequently used to lessen the risk of recurrent embolism but there are insufficient data to draw firm conclusions about its efficacy. Further research to optimize management of persons at risk for cardioembolic stroke is needed.