2012, Number 3
Gac Med Mex 2012; 148 (3)
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ABSTRACTStroke is the second most common cause of death in the world and produces a high number of cases with neurological dysfunction. Atrial fibrillation (AF) is the main risk factor in patients with cardioembolic stroke. In Mexico, there are approximately 850,000 patients with AF. In three stroke and TIA Mexican series including 3,194 patients, the frequency of AF in cases of stroke and TIA were 12.5 and 8.1%, respectively. AF increase stroke risk in six times.
Different approaches to AF detection in stroke patients have been postulated. Besides electrocardiogram, non-invasive cardiac monitoring is useful for AF detection. Is very important to detect particular subgroups with high risk of paroxysmal AF, including those with cryptogenic stroke.
Is important to stratify the risk of stroke in patients with AF. More than a dozen of scales have been proposed. CHADS2 is one of the most commonly used, and recently another one has been proposed (CHA2DS2-VASc).
Warfarin has been successfully used in stroke prevention in AF. However need of coagulation monitoring as well diet and drugs restriction limit their use. New oral anticoagulants without these restrictions as well low rates of hemorrhagic complications are now available.