The prognostication and prevention of cardioembolic stroke in patients with atria fibrillation

Abstract

The study was organized to discover along with common factors the factors associated with old disturbed cerebral blood circulation in patients with atria fibrillation and to detect rate of prescription of anticoagulant therapy. The examined sample included 768 patients with atria fibrillation. The patients were separated by two groups. The first group included 135 patients with old stroke or transitory ischemic attack. The second group included 633 patients without the given complications in anamnesis. The milti-factorial analysis established that ratio of chances of development of stroke for permanent form of atria fibrillation consisted 1.24 (confidence interval 95%, 1.06-1.45; p=0.007), for age 64 years and older - 1.1 (confidence interval 95%, 1.02-1.45; p=0.0001) and for diabetes mellitus - 1.2 (confidence interval 95%, 1.05-1.5; p=0.04). The anticoagulant therapy was prescribed to 52 patients (38.5%) from first group and 260 patients (41%) from second group. Out of anti-thrombocyte pharmaceuticals 38 patients (12%) were prescribed Rivaroxaban, 10 patients (3.2%) - Dabigatran etexilate and 264 patients (84.6 %) - antagonists of vitamin K. Along with common factors (female gender, age 64 years and older, arterial hypertension, diabetes mellitus, old myocardium infarction) in patients with atria fibrillation the risk of development of disturbed cerebral blood circulation is associated with permanent form of atria fibrillation, duration of atria fibrillation longer than 18 months, level of fibrinogen higher than 4.3 g/l. The anticoagulant therapy takes first place as mode of preventing of thromboembolic complications in patients with atria fibrillation. However, in practice rate of prescription of anticoagulant therapy consists less than 45%.

Keywords

atria fibrillation / old disturbed cerebral blood circulation / anticoagulant therapy

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