Atrial Fibrillation in Cerebrovascular Disease: National Neurological Perspective
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | por eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/85 |
Resumo: | Background: Cardioembolism due to atrial fibrillation assumes a dominant etiologic role in cerebrovascular diseases due to its growing incidence, high embolic risk and particular aspects of clinical events caused. Our objectives are to analyze the frequency of atrial fibrillation in patients with ischemic stroke, study the vital and functional impact of stroke due to different etiologies and evaluate antithrombotic options before and after stroke. Methods: We conducted a retrospective study including patients admitted in a central hospital due to ischemic stroke in 2010 (at least one year of follow-up). Etiology of stroke was defined using the Trial of ORG 10172 in Acute Stroke (TOAST) classification, and functional outcome by modified Rankin scale. We performed a descriptive analysis of different stroke etiologies and antithrombotic medication in patients with atrial fibrillation. We then conducted a cohort study to evaluate the clinical impact of antithrombotic options in secondary prevention after cardioembolic stroke. Results: In our population (n = 631) we found superior frequency of cardioembolism (34.5%) to that reported in the literature. Mortality, morbidity and antithrombotic options are similar to other previous series, confirming the severity of cardioembolic strokes and the underuse of vitamin K antagonists. Oral anticoagulation was effective in secondary prevention independently from post-stroke functional condition. Conclusions: Despite unequivocal recommendations, oral anticoagulation is still underused in stroke prevention. This study confirms the clinical efficacy of vitamin K antagonists in secondary prevention independently from residual functional impairment. |
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Atrial Fibrillation in Cerebrovascular Disease: National Neurological PerspectiveFibrilhação Auricular na Doença Cerebrovascular: A Perspectiva Neurológica NacionalBackground: Cardioembolism due to atrial fibrillation assumes a dominant etiologic role in cerebrovascular diseases due to its growing incidence, high embolic risk and particular aspects of clinical events caused. Our objectives are to analyze the frequency of atrial fibrillation in patients with ischemic stroke, study the vital and functional impact of stroke due to different etiologies and evaluate antithrombotic options before and after stroke. Methods: We conducted a retrospective study including patients admitted in a central hospital due to ischemic stroke in 2010 (at least one year of follow-up). Etiology of stroke was defined using the Trial of ORG 10172 in Acute Stroke (TOAST) classification, and functional outcome by modified Rankin scale. We performed a descriptive analysis of different stroke etiologies and antithrombotic medication in patients with atrial fibrillation. We then conducted a cohort study to evaluate the clinical impact of antithrombotic options in secondary prevention after cardioembolic stroke. Results: In our population (n = 631) we found superior frequency of cardioembolism (34.5%) to that reported in the literature. Mortality, morbidity and antithrombotic options are similar to other previous series, confirming the severity of cardioembolic strokes and the underuse of vitamin K antagonists. Oral anticoagulation was effective in secondary prevention independently from post-stroke functional condition. Conclusions: Despite unequivocal recommendations, oral anticoagulation is still underused in stroke prevention. This study confirms the clinical efficacy of vitamin K antagonists in secondary prevention independently from residual functional impairment.Introdução: A cardioembolia por fibrilhação auricular assume particular destaque etiológico nas doenças vasculares cerebrais devido à sua crescente incidência, elevado risco embólico e particularidades dos eventos clínicos causados. São objectivos deste trabalho analisar a frequência da fibrilação auricular numa população de doentes com acidente vascular cerebral isquémico observados num hospital nacional, estudar o impacto vital e funcional dos acidentes vasculares cerebrais causados por diferentes etiologias, e avaliar as opções antitrombóticas prévias e posteriores ao acidente vascular cerebral. Metodologia: Realizámos um estudo observacional retrospectivo incluindo todos os doentes internados num hospital central por acidente vascular cerebral isquémico em 2010 (pelo menos um ano de seguimento). A etiologia do acidente vascular cerebral foi definida pela classificação Trial of ORG 10172 in Acute Stroke (TOAST) modificada e o resultado funcional pela escala Rankin modificada. Realizámos análise descritiva das diferentes etiologias de acidente vascular cerebral e das prescrições antitrombóticas a doentes com fibrilhação auricular. Realizámos ainda um estudo de coorte para estudar o impacto clínico das opções antitrombóticas em prevenção secundária após acidente vascular cerebral cardioembólico. Resultados: Na nossa população (n = 631) encontramos frequência de cardioembolia (34,5%) superior à relatada na literatura. Os valores de mortalidade e morbilidade além das opções terapêuticas antitrombóticas em pré e pós-Doença Vascular Cerebral são semelhantes aos de outras séries, confirmando a gravidade dos acidentes vasculares cerebrais cardioembólicos e a subutilização dos antagonistas da vitamina K. A anticoagulação oral foi eficaz em prevenção secundária independentemente do estado funcional sequelar após acidente vascular cerebral. Conclusões: Apesar das recomendações terapêuticas inequívocas a anticoagulação oral continua a ser subutilizada em prevenção de Doença Vascular Cerebral. Confirmamos a eficácia clínica dos antagonistas da vitamina K em prevenção secundária, independentemente das limitações funcionais sequelares.Ordem dos Médicos2013-06-05info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfimage/tiffimage/tiffimage/tiffapplication/mswordhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/85oai:ojs.www.actamedicaportuguesa.com:article/85Acta Médica Portuguesa; Vol. 26 No. 2 (2013): March-April; 86-92Acta Médica Portuguesa; Vol. 26 N.º 2 (2013): Março-Abril; 86-921646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/85https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/85/3219https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/85/4129https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/85/6875https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/85/6876https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/85/6877https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/85/6878Sargento-Freitas, JoaoSilva, FernandoKoehler, SebastianIsidoro, LuísMendonça, NunoMachado, CristinaCordeiro, GustavoCunha, Luísinfo:eu-repo/semantics/openAccess2022-12-20T10:55:48Zoai:ojs.www.actamedicaportuguesa.com:article/85Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:16:22.230358Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Atrial Fibrillation in Cerebrovascular Disease: National Neurological Perspective Fibrilhação Auricular na Doença Cerebrovascular: A Perspectiva Neurológica Nacional |
title |
Atrial Fibrillation in Cerebrovascular Disease: National Neurological Perspective |
spellingShingle |
Atrial Fibrillation in Cerebrovascular Disease: National Neurological Perspective Sargento-Freitas, Joao |
title_short |
Atrial Fibrillation in Cerebrovascular Disease: National Neurological Perspective |
title_full |
Atrial Fibrillation in Cerebrovascular Disease: National Neurological Perspective |
title_fullStr |
Atrial Fibrillation in Cerebrovascular Disease: National Neurological Perspective |
title_full_unstemmed |
Atrial Fibrillation in Cerebrovascular Disease: National Neurological Perspective |
title_sort |
Atrial Fibrillation in Cerebrovascular Disease: National Neurological Perspective |
author |
Sargento-Freitas, Joao |
author_facet |
Sargento-Freitas, Joao Silva, Fernando Koehler, Sebastian Isidoro, Luís Mendonça, Nuno Machado, Cristina Cordeiro, Gustavo Cunha, Luís |
author_role |
author |
author2 |
Silva, Fernando Koehler, Sebastian Isidoro, Luís Mendonça, Nuno Machado, Cristina Cordeiro, Gustavo Cunha, Luís |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Sargento-Freitas, Joao Silva, Fernando Koehler, Sebastian Isidoro, Luís Mendonça, Nuno Machado, Cristina Cordeiro, Gustavo Cunha, Luís |
description |
Background: Cardioembolism due to atrial fibrillation assumes a dominant etiologic role in cerebrovascular diseases due to its growing incidence, high embolic risk and particular aspects of clinical events caused. Our objectives are to analyze the frequency of atrial fibrillation in patients with ischemic stroke, study the vital and functional impact of stroke due to different etiologies and evaluate antithrombotic options before and after stroke. Methods: We conducted a retrospective study including patients admitted in a central hospital due to ischemic stroke in 2010 (at least one year of follow-up). Etiology of stroke was defined using the Trial of ORG 10172 in Acute Stroke (TOAST) classification, and functional outcome by modified Rankin scale. We performed a descriptive analysis of different stroke etiologies and antithrombotic medication in patients with atrial fibrillation. We then conducted a cohort study to evaluate the clinical impact of antithrombotic options in secondary prevention after cardioembolic stroke. Results: In our population (n = 631) we found superior frequency of cardioembolism (34.5%) to that reported in the literature. Mortality, morbidity and antithrombotic options are similar to other previous series, confirming the severity of cardioembolic strokes and the underuse of vitamin K antagonists. Oral anticoagulation was effective in secondary prevention independently from post-stroke functional condition. Conclusions: Despite unequivocal recommendations, oral anticoagulation is still underused in stroke prevention. This study confirms the clinical efficacy of vitamin K antagonists in secondary prevention independently from residual functional impairment. |
publishDate |
2013 |
dc.date.none.fl_str_mv |
2013-06-05 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
format |
article |
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publishedVersion |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/85 oai:ojs.www.actamedicaportuguesa.com:article/85 |
url |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/85 |
identifier_str_mv |
oai:ojs.www.actamedicaportuguesa.com:article/85 |
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por eng |
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por eng |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/85 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/85/3219 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/85/4129 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/85/6875 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/85/6876 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/85/6877 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/85/6878 |
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Ordem dos Médicos |
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Ordem dos Médicos |
dc.source.none.fl_str_mv |
Acta Médica Portuguesa; Vol. 26 No. 2 (2013): March-April; 86-92 Acta Médica Portuguesa; Vol. 26 N.º 2 (2013): Março-Abril; 86-92 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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