Stroke in Atrial Fibrillation and Other Atrial Dysrhythmias

Ozdemir, hizir, Sagris, Dimitrios, Lip, Gregory and Abdul Rahim, Azmil Husin ORCID: 0000-0002-1318-4027 (2023) Stroke in Atrial Fibrillation and Other Atrial Dysrhythmias. Current Cardiology Reports, 25 (5). pp. 357-369.

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Abstract

<h4>Purpose of review</h4>Atrial fibrillation (AF) is a major risk factor for systemic embolism and ischaemic stroke. Furthermore, AF-related strokes are associated with higher mortality, greater disability, longer hospital stays and lower rates of hospital discharge than strokes caused by other reasons. The aim of this review to summarise the existing evidence on the association of AF with ischemic stroke and provide insights on the pathophysiological mechanisms and the clinical management of patients with AF in order to reduce the burden of ischemic stroke.<h4>Recent findings</h4>Beyond Virchow's triad, several pathophysiological mechanisms associated with structural changes in the left atrium, which may precede the identification of AF, may contribute to the increased risk of arterial embolism in AF patients. Individualised thromboembolic risk stratification based on CHA₂DS₂-VASc score and clinically relevant biomarkers provides essential tool towards a personalised holistic approach in thromboembolism prevention. Anticoagulation remains the cornerstone of stroke prevention moving from vitamin K antagonists (VKA) to safer non-vitamin K direct oral anticoagulants in the majority of AF patients. Despite the efficacy and safety of oral anticoagulation, still the equilibrium between thrombosis and haemostasis in AF patients remains suboptimal and future directions in anticoagulation and cardiac intervention may provide novel treatment options in stroke prevention. This review summarises the pathophysiologic mechanisms of thromboembolism, aiming the current and potential future perspectives in stroke prevention in AF patients.

Item Type:	Article
Uncontrolled Keywords:	Stroke, Atrial fibrillation, Risk stratification, Anticoagulant
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User:	Symplectic Admin
Date Deposited:	16 Mar 2023 08:37
Last Modified:	28 Mar 2024 02:30
DOI:	10.1007/s11886-023-01862-1
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3169125