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Issues of improving the management of patients with ischemic stroke on the background of atrial fibrillation

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The article discusses the clinical features of cardioembolic stroke (CES). Approaches to the examination of a patient with clinical suspicion of CES are discussed within the framework of the concept of atrial cardiopathy and its main markers. The principles for choosing the timing of oral anticoagulant administration for the purpose of secondary prevention are presented. The article discusses the special aspects of direct oral anticoagulants prescription in difficult clinical situations, in particular, in elderly and senile patients, after reperfusion therapy, with the development of hemorrhagic transformation, in the presence of combined atherosclerosis, cerebral microangiopathy, anamnesis of intracerebral hemorrhage, as well as severe cognitive impairment. Approaches to the choice of oral anticoagulant in terms of purely clinical benefit are presented.

About the Authors

A. A. Kulesh
Department of neurology and medical genetics, Acad. E.A. Vagner Perm State Medical University, Ministry of Health of Russia
Russian Federation

Aleksey Aleksandrovich Kulesh

614990, Perm, Petropavlovskaya St., 26

Competing Interests:

There are no conflicts of interest.

D. A. Demin
Federal Center for Cardiovascular Surgery, Ministry of Health of Russia
Russian Federation

414011, Astrakhan, Pokrovskaya Rosha St., 4

Competing Interests:

There are no conflicts of interest.


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For citations:

Kulesh A.A., Demin D.A. Issues of improving the management of patients with ischemic stroke on the background of atrial fibrillation. Neurology, Neuropsychiatry, Psychosomatics. 2022;14(6):115-121. (In Russ.)

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ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)