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ISSN 2448-5640 (Print)
Diario Oficial de la Sociedad Mexicana de Cirugía Cardiaca, A.C., y del Colegio Mexicano de Cirugía Cardiovascular y Torácica, A.C.

2017, Number 2

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Cir Card Mex 2017; 2 (2)

Warfarina y hemorragia cerebral

García-Villarreal OA

Language: Spanish
References: 19
Page: 60-62
PDF size: 191.74 Kb.


ABSTRACT

The possibility of stroke in patients with non-valvular atrial fibrillation is 5 times higher, and up to 17 times higher with valvular atrial fibrillation compared to the general population. Warfarin therapy reduces up to 6 times the possibility of stroke. Recommended INR levels for proper AF management are between 2.0 and 3.9. The possibility of stroke with INR ‹2.0 is 18% per year (OR = 1.9). The possibility of intracranial hemorrhage with INR› 4.5 is 9.4% per year. Intracranial hemorrhage is more frequent as intracerebral hemorrhage (70%), and the rest are mainly subdural hemorrhages. Intracerebral hemorrhage has an absoult early mortality of 60%, while for subdural hemorrhage is 15-20%. This last one is more amenable to surgical treatment and reversal of anticoagulation. Antiplatelet therapy reduces the possibility of stroke in non-valvular atrial fibrillation by only 20%.


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