acenocoumarol and Cerebrovascular-Disorders

Topics: Acenocoumarol; Angina Pectoris; Anticoagulants; Cerebrovascular Disorders; Dicumarol; Heparin; Humans; Myocardial Infarction; Phlebitis; Rheumatic Heart Disease; Thromboembolism; Thrombophlebitis; Warfarin

The aim of the present study was to evaluate the impact of the results of clinical trials on the prophylactic treatment of non-rheumatic atrial fibrillation with oral anticoagulants.. Retrospectively, we studied a random sample of 375 patients discharged from our hospital with a diagnosis of non-rheumatic atrial fibrillation between 1991 and 1993. Information about diagnoses, other clinical variables and treatments prescribed at discharge was obtained from the hospital medical records.. During the whole study period, 14% of patients were prescribed an oral anticoagulant agent and 17% were prescribed acetylsalicylic acid. A non-significant increase in the proportion of patients prescribed oral anticoagulant drugs, from 9% to 17%, was observed. Multivariate analysis showed that a history of stroke (OR = 5.96) and younger age were significantly associated with the prescription of oral anticoagulants. ASA prescription was strongly associated with a history of concomitant vascular disease (OR = 5.8), but not with other risk factors for stroke. Sixty-five percent of patients had one or more risk factors for stroke, did not present any contraindications to anticoagulant agents, but nevertheless were not prescribed one of these drugs.. Anticoagulant agents and acetylsalicylic acid were largely underprescribed to patients with non-rheumatic atrial fibrillation, and oral anticoagulants were not prescribed according to the individual patients' risk of stroke.

Topics: Acenocoumarol; Administration, Oral; Adult; Aged; Aged, 80 and over; Anticoagulants; Aspirin; Atrial Fibrillation; Cerebrovascular Disorders; Clinical Trials as Topic; Contraindications; Female; Humans; Male; Middle Aged; Retrospective Studies; Risk Factors

During a 5-year period, 85 patients with TIAs, 65 patients with embolic brain ischemia of cardiac source and 50 patients with progressing stroke received intravenous heparin within 96 h. Twelve (6%) developed an early bleeding in the area involved by ischemia. In the 2 cases with transient ischemic attacks (TIAs) (2.3%), major functional sequelae persisted and the 2 cases with emboli from heart (3.2%) died, whereas among the 8 cases with progressing stroke (16%), only 3 worsened from anticoagulant-induced bleeding. Intracerebral bleeding was not associated with excessive anticoagulation or high blood pressure and was related to a large infarction only in the cases with emboli from the heart. Among the 108 patients who were placed on acenocoumarol during 3-12 months after heparin therapy, only one (0.9%) suffered a hemorrhagic infarct from a probable recurrent embolization. The risk of anticoagulant-induced intracerebral bleeding is quite different between the varieties of preceding ischemic events, with different subsequent impact on prognosis.

Topics: Acenocoumarol; Aged; Brain Ischemia; Cerebral Hemorrhage; Cerebrovascular Disorders; Female; Heart Diseases; Heparin; Humans; Intracranial Embolism and Thrombosis; Ischemic Attack, Transient; Male; Middle Aged

Topics: Acenocoumarol; Adolescent; Adult; Age Factors; Aged; Ambulatory Care; Cerebrovascular Disorders; Child; Child, Preschool; Female; Humans; Infant; Male; Middle Aged; Myocardial Infarction; Netherlands; Phenprocoumon; Postoperative Complications; Thrombosis

Topics: Acenocoumarol; Blood Coagulation; Cerebrovascular Disorders; Electrocardiography; Fibrinogen; Heparin; Humans; Hypertension; Intracranial Arteriosclerosis; Thrombelastography

Topics: Acenocoumarol; Carotid Artery Thrombosis; Cerebral Arterial Diseases; Cerebrovascular Circulation; Cerebrovascular Disorders; Ethyl Biscoumacetate; Hemiplegia; Heparin; Hibernation; Humans; Hypothermia, Induced; Intracranial Embolism; Intracranial Embolism and Thrombosis; Promazine; Stroke; Therapeutics; Thrombosis; Toxicology

Topics: Acenocoumarol; Cerebral Cortex; Cerebral Infarction; Cerebrovascular Disorders; Drug Therapy; Hemiplegia; Humans; Infarction; Stroke; Toxicology

Topics: Acenocoumarol; Aged; Anticoagulants; Cerebrovascular Disorders; Coronary Disease; Dicumarol; Drug Therapy; Ethyl Biscoumacetate; Geriatrics; Humans; Incidence; Middle Aged; Mortality; Neoplasm Metastasis; Neoplasms; Pathology; Phenindione; Thromboembolism; Warfarin