Are Ischemic Strokes the Same? The Special Case Argument of Atrial Fibrillation

Abstract

A comprehensive evaluation is necessary to identify the etiologic factors in order to select optimal stroke-prevention measures. Atrial fibrillation is one of the most important stroke causes. Although anticoagulant therapy is the treatment of choice for patients with nonvalvular atrial fibrillation, it should not be considered uniformly to treat all patients given the high mortality associated with anticoagulant-related hemorrhages. The authors propose a risk-stratified individualized approach for stroke prevention in patients with nonvalvular atrial fibrillation by considering nonpharmacologic approaches for patients at high hemorrhage risk or otherwise unsuitable for lifelong anticoagulation.

Keywords: Anticoagulation; Atrial fibrillation; Intracerebral hemorrhage; Ischemic stroke; Left atrial appendage closure; Stroke prevention.