With ever increasing number of patients with Atrial Fibrillation we do see patients presenting with cardioembolic stroke. One of the frequent questions that gets asked when to start anticoagulation and how? I have always practiced starting warfarin after 10 days and always bridge with Low molecular weight heparin. After reading this study i should change my practice..
Conclusions:- Anticoagulation of patients with cardioembolic stroke can be safely started with warfarin shortly after stroke. Heparin bridging and enoxaparin bridging increase the risk for serious bleeding.
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Conclusions:- Anticoagulation of patients with cardioembolic stroke can be safely started with warfarin shortly after stroke. Heparin bridging and enoxaparin bridging increase the risk for serious bleeding.
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3 comments:
goof
how many days post event would it be best to initiate warfarin?
Early hemorrhagic transformation happens in 72 hours. So i would start after 3 days. If you agree with this study i would start without bridging.
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