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Jung KH, Yu KH, Kim YD, et al. Antithrombotic Management of Patients with Nonvalvular Atrial Fibrillation and Ischemic Stroke or Transient Ischemic Attack: Executive Summary of the Korean Clinical Practice Guidelines for Stroke. J Stroke. 2015;17(2):210-5doi: 10.5853/jos.2015.17.2.210.
Jung, K. H., Yu, K. H., Kim, Y. D., Park, J. M., Hong, K. S., Rha, J. H., Kwon, S. U., Bae, H. J., Heo, J. H., Lee, B. C., & Yoon, B. W. (2015). Antithrombotic Management of Patients with Nonvalvular Atrial Fibrillation and Ischemic Stroke or Transient Ischemic Attack: Executive Summary of the Korean Clinical Practice Guidelines for Stroke. Journal of stroke, 17(2), 210-5. https://doi.org/10.5853/jos.2015.17.2.210
Jung, Keun-Hwa, et al. "Antithrombotic Management of Patients with Nonvalvular Atrial Fibrillation and Ischemic Stroke or Transient Ischemic Attack: Executive Summary of the Korean Clinical Practice Guidelines for Stroke." Journal of stroke vol. 17,2 (2015): 210-5. doi: https://doi.org/10.5853/jos.2015.17.2.210
Jung KH, Yu KH, Kim YD, Park JM, Hong KS, Rha JH, Kwon SU, Bae HJ, Heo JH, Lee BC, Yoon BW. Antithrombotic Management of Patients with Nonvalvular Atrial Fibrillation and Ischemic Stroke or Transient Ischemic Attack: Executive Summary of the Korean Clinical Practice Guidelines for Stroke. J Stroke. 2015 May;17(2):210-5. doi: 10.5853/jos.2015.17.2.210. Epub 2015 May 29. PMID: 26060808; PMCID: PMC4460340.
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J Stroke. 2015 May;17(2):210-5. doi: 10.5853/jos.2015.17.2.210. Epub 2015 May 29.

Antithrombotic Management of Patients with Nonvalvular Atrial Fibrillation and Ischemic Stroke or Transient Ischemic Attack: Executive Summary of the Korean Clinical Practice Guidelines for Stroke.

Journal of stroke

Keun-Hwa Jung, Kyung-Ho Yu, Young Dae Kim, Jong-Moo Park, Keun-Sik Hong, Joung-Ho Rha, Sun U Kwon, Hee-Joon Bae, Ji Hoe Heo, Byung-Chul Lee, Byung-Woo Yoon

Affiliations

  1. Department of Neurology, Seoul National University Hospital, Seoul, Korea.
  2. Department of Neurology, Hallym Neurological Institute, Anyang, Korea.
  3. Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
  4. Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Korea.
  5. Department of Neurology, Ilsan Paik Hospital, Inje University, Goyang, Korea.
  6. Department of Neurology, Inha University Hospital, Incheon, Korea.
  7. Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
  8. Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea.

PMID: 26060808 PMCID: PMC4460340 DOI: 10.5853/jos.2015.17.2.210

Abstract

Cardioembolic stroke related to nonvalvular atrial fibrillation is associated with a high recurrence rate and high mortality and morbidity. In this population, therefore, optimal anticoagulant therapy is required to prevent the occurrence of second stroke. Oral anticoagulant, warfarin has been traditionally used, but it is greatly limited by its narrow efficacy window, complex pharmacokinetics, and multiple drug interactions, thus requiring frequent blood monitoring. Recently, oral anticoagulants targeted for a specific coagulation component have been newly developed and tested in large clinical trials. Dabigatran, direct thrombin inhibitor, and rivaroxaban, apixaban, and edoxaban, inhibitors of factor Xa harbor great merits of rapid action time, short half-life, stable plasma concentration, and little drug interaction. Recently, large randomized clinical trials and meta-analyses have been published to show the efficacy and safety of the new oral anticoagulants compared with warfarin. Based on the results from recent clinical trials, we revised recommendations to apply optimal anticoagulant therapy in patients with nonvalvular atrial fibrillation and ischemic stroke or transient ischemic attack.

Keywords: Atrial fibrillation; New anticoagulant; Secondary prevention; Stroke; Warfarin

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