anticoagulación oral

Riesgo Cardiovascular en el Uso de Anticoagulación Oral Posterior a Hemorragia Intracerebral: ¿Qué Desenlaces Considerar?

To the Editor:

The use of oral anticoagulation in patients with atrial fibrillation has been shown to significantly reduce thromboembolic events, including ischemic stroke. However, this therapeutic strategy poses significant clinical dilemmas in survivors of intracerebral hemorrhage (ICH), where the risk of rebleeding is weighed against the potential benefit of preventing new ischemic events. Despite the advancement of direct oral anticoagulants (DOACs), a critical gap in evidence remains to guide optimal management in this high-risk subgroup, particularly regarding the selection of neurological outcomes of greatest interest.

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Palabras clave: anticoagulación oral, Hemorragia intracerebral, riesgo cardiovascular,

Keywords: cardiovascular risk, Intracerebral hemorrhage, oral anticoagulation,

Riesgo de enfermedad cerebrovascular en la fibrilación auricular. Hospital Lenin Enero 2006 – Diciembre 2007.

A case-series was performed in the Emergency Service of the University Hospital V. I. Lenin. The universe of the study was 413 patients in Observation at the Emergency Service of Internal Medicine. Considered as an objective was to determine the behavior of the different clinical, epidemiological and therapeutic variables of the patients with atrial fibrillation and with risk to develop cerebrovascular disease. Of these patients, 165 were selected according to the inclusion criteria. The main results were that the most frequent clinical pattern of presentation was recent diagnosis followed by recurrent and permanent diagnosis and that after 60 years of age the highest risk to develop stroke was in patients with permanent clinical pattern which were not properly protected to prevent it. We concluded that if cerebrovascular disease is to be prevented, then it is necessary to give the patients the proper anticoagulants and antiplatelet medications. We recommend insisting in the application of the protocols of management.