Early anticoagulation using low-dose heparin following cardioembolic stroke with nonvalvular atrial fibrillation in the elderly
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Nonvalvular atrial fibrillation (NVAF) is emphasized as a cause of cardioembolic stroke. However little has been investigated about the role of early anticoagulation for preventing early recurrence in elderly cardioembolic stroke patients with NVAF. Here we present the results of early anticoagulation therapy using low-dose heparin in elderly patients with cardioembolic stroke and NVAF, and compare them retrospectively with the rates of recurrence and hemorrhagic accident in untreated patients. Forty-one elderly patients who were admitted to our hospital from July 1992 to May 1998 with NVAF were treated with low-dose heparin (5000 IU/day) immediately after cardioembolic stroke (H+ group, mean age; 84.9). Only one patient (2.4%) suffered recurrent embolism, and 11 patients (26.8%) showed hemorrhagic infarction on CT within 28 days after the initial stroke. Severe hemorrhagic complications were not observed. In a control group (H - group, mean age; 80. 1), who were admitted to our hospital from July 1986 to July 1992 and treated only with conservative therapy, recurrent embolic stroke occurred in 6 (16.2%) of 37 patients, and hemorrhagic infarction was found in 15 (40.5%). Significantly fewer patients suffered recurrent embolism in the H + group than in the H - group (p<0.05). There was no significant different in the occurrence of hemorrhagic infarction between the two groups. We conclude that acute anticoagulation using low-dose heparin is employed safely, and prevent recurrent embolism during the acute phase in most elderly patients.
- 一般社団法人 日本脳卒中学会の論文
一般社団法人 日本脳卒中学会 | 論文
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