Cervera Alvaro, Chamorro Angel
Comprehensive Stroke Center, Hospital Clínic; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Barcelona, Spain.
Curr Cardiol Rev. 2010 Aug;6(3):227-37. doi: 10.2174/157340310791658749.
Anticoagulation is indicated in most cardioembolic ischemic strokes for secondary prevention. In many cardiac conditions, anticoagulation is also indication for primary stroke prevention, mainly when associated to vascular risk factors. Anticoagulation should be started as soon as possible, as it is safe even in moderate acute strokes. The efficacy of early anticoagulation after cardioembolic stroke in relation to outcome has not been assessed adequately, but there is evidence from animal models and clinical studies that anticoagulation with unfractionated heparin is associated with a better outcome mediated in part by its anti-inflammatory properties.
大多数心源性栓塞性缺血性卒中患者需要进行抗凝治疗以预防复发。在许多心脏疾病中,抗凝治疗也是预防卒中的主要措施,主要适用于伴有血管危险因素的患者。抗凝治疗应尽早开始,因为即使是中度急性卒中患者,抗凝治疗也是安全的。心源性栓塞性卒中后早期抗凝治疗对预后的影响尚未得到充分评估,但动物模型和临床研究表明,普通肝素抗凝治疗能部分通过其抗炎特性改善预后。