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비타민K비의존경구항응고제 사용 후 안정화된 재발뇌경색

A Recurrent Ischemic Stroke Stabilization after Using Non-Vitamin K Antagonist Oral Anticoagulant (NOAC)

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초록

Current stroke guidelines recommend the administration of non-vitamin-K-antagonist oral anticoagulant (NOAC) for the prevention of cardioembolic stroke induced by nonvalvular atrial fibrillation. We report a patient who suffered from recurrent posterior circulation strokes—occurring eight times in 4 months—even under adequate antiplatelet medication. Changing the medication from antiplatelet agents to NOAC stopped the stroke recurrence. We suggest that NOAC has a role in the prevention of recurrent stroke of undetermined etiology in the posterior circulation.

Abstract

Current stroke guidelines recommend the administration of non-vitamin-K-antagonist oral anticoagulant (NOAC) for the prevention of cardioembolic stroke induced by nonvalvular atrial fibrillation. We report a patient who suffered from recurrent posterior circulation strokes—occurring eight times in 4 months—even under adequate antiplatelet medication. Changing the medication from antiplatelet agents to NOAC stopped the stroke recurrence. We suggest that NOAC has a role in the prevention of recurrent stroke of undetermined etiology in the posterior circulation.

참고문헌 (7)

  1. Adams RJ, "Update to the AHA", ASA recommendations for the prevention of stroke in patients with stroke and transient ischemic attack, 2008, pp.39, 1647~1652
  2. Song, SH, "Recurrent posterior circulation infarction caused by anomalous occipital bony process in a young patient", BMC Neurol, 14, pp.252~ (2014)
  3. Anand SS, "Oral anticoagulant therapy in patients with coronary artery disease: a meta-analysis", JAMA, 282, pp.2058~2067 (1999)
  4. Mega JL, "Rivaroxaban in patients with a recent acute coronary syndrome", N Engl J Med, 366, pp.9~19 (2012)
  5. Dressler FA, "Mobile aortic atheroma and systemic emboli: efficacy of anticoagulation and influence of plaque morphology on recurrent stroke", J Am Coll Cardiol, 31, pp.134~138 (1998)
  6. ESPRIT Study Group, "Medium intensity oral anticoagulants versus aspirin after cerebral ischaemia of arterial origin (ESPRIT): a randomised controlled trial", Lancet Neurol, 6, pp.115~124 (2007)
  7. Hart RG, "Embolic strokes of undetermined source: the case for a new clinical construct", Lancet Neurol, 13, pp.429~438 (2014)

관련 논문AI추천

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