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Updates on Prevention of Cardioembolic Strokes

김동억|Liping Liu|M. Edip Gurol|Mehmet Akif Topcuoglu
대한뇌졸중학회 (The Korean Stroke Society)|2018.05|대한뇌졸중영문학회지 (Journal of stroke)|제20권 제2호|pp. 180-196

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참고문헌

키워드

AnticoagulantsIschemic strokeAtrial fibrillationLeft atrial appendage closureCardioembolismPatent foramen ovale closure
주제분류신경과학

초록

Cardiac embolism continues to be a leading etiology of ischemic strokes worldwide. Although pathologies that result in cardioembolism have not changed over the past decade, there have been significant advances in the treatment and stroke prevention methods for these conditions. Atrial fibrillation remains the prototypical cause of cardioembolic strokes. The availability of new long-term monitoring devices for atrial fibrillation detection such as insertable cardiac monitors has allowed accurate detection of this leading cause of cardioembolism. The non-vitamin K antagonist oral anticoagulants have improved our ability to prevent strokes for many patients with non-valvular atrial fibrillation (NVAF). Advances in left atrial appendage closure and the U.S. Food and Drug Administration approval of the WATCHMAN (Boston Scientific) device for stroke prevention in NVAF patients who have an appropriate rationale for a nonpharmacological alternative, have revolutionized the field and provided a viable option for patients at higher hemorrhagic risk. The role of patent foramen ovale closure for secondary prevention in selected patients experiencing cryptogenic ischemic strokes at a relatively young age has become clearer thanks to the very recent publication of long-term outcomes from three major studies. Advances in the management of infective endocarditis, heart failure, valvular diseases, and coronary artery disease have significantly changed the management of such patients, but have also revealed new concerns related to assessment of ischemic versus hemorrhagic risk in the setting of antithrombotic use. The current review article aims to discuss these advances especially as they pertain to the stroke neurology practice.

Abstract

Cardiac embolism continues to be a leading etiology of ischemic strokes worldwide. Although pathologies that result in cardioembolism have not changed over the past decade, there have been significant advances in the treatment and stroke prevention methods for these conditions. Atrial fibrillation remains the prototypical cause of cardioembolic strokes. The availability of new long-term monitoring devices for atrial fibrillation detection such as insertable cardiac monitors has allowed accurate detection of this leading cause of cardioembolism. The non-vitamin K antagonist oral anticoagulants have improved our ability to prevent strokes for many patients with non-valvular atrial fibrillation (NVAF). Advances in left atrial appendage closure and the U.S. Food and Drug Administration approval of the WATCHMAN (Boston Scientific) device for stroke prevention in NVAF patients who have an appropriate rationale for a nonpharmacological alternative, have revolutionized the field and provided a viable option for patients at higher hemorrhagic risk. The role of patent foramen ovale closure for secondary prevention in selected patients experiencing cryptogenic ischemic strokes at a relatively young age has become clearer thanks to the very recent publication of long-term outcomes from three major studies. Advances in the management of infective endocarditis, heart failure, valvular diseases, and coronary artery disease have significantly changed the management of such patients, but have also revealed new concerns related to assessment of ischemic versus hemorrhagic risk in the setting of antithrombotic use. The current review article aims to discuss these advances especially as they pertain to the stroke neurology practice.

참고문헌 (90)

  1. Gokcal E, "Atrial fibrillation for the neurologist: preventing both ischemic and hemorrhagic strokes", Curr Neurol Neurosci Rep, 18, pp.6~ (2018)[DOI]
  2. Steffel J, "The 2018 European Heart Rhythm Association practical guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation", Eur Heart J, 39, pp.1330~1393 (2018)[DOI]
  3. Gurol ME, "Nonpharmacological management of atrial fibrillation in patients at high intracranial hemorrhage risk", Stroke, 49, pp.247~254 (2018)[DOI]
  4. Mas JL, "Patent foramen ovale closure or anticoagulation vs. antiplatelets after stroke", N Engl J Med, 377, pp.1011~1021 (2017)[DOI]
  5. Saver JL, "Long-term outcomes of patent foramen ovale closure or medical therapy after stroke", N Engl J Med, 377, pp.1022~1032 (2017)[DOI]
  6. Sondergaard L, "Patent foramen ovale closure or antiplatelet therapy for cryptogenic stroke", N Engl J Med, 377, pp.1033~1042 (2017)[DOI]
  7. Krishnamurthi RV, "Global and regional burden of first-ever ischaemic and haemorrhagic stroke during 1990-2010: findings from the Global Burden of Disease Study 2010", Lancet Glob Health, 1, pp.e259~e281 (2013)[DOI]
  8. Hsin-Hsi Tsai, "Updates on Prevention of Hemorrhagic and Lacunar Strokes", 대한뇌졸중영문학회지, 20(2), pp.167~179 (2018), 대한뇌졸중학회
  9. January CT, "2014 AHA", ACC, American Heart Association Task Force on practice guidelines and the Heart Rhythm Society, pp.Circulation, 2014[DOI]
  10. Kirchhof P, "2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS", Eur Heart J, 37, pp.2893~2962 (2016)[DOI]
  11. McManus DD, "An update on the prognosis of patients with atrial fibrillation", Circulation, 126, pp.e143~e146 (2012)[DOI]
  12. Benjamin EJ, "Heart disease and stroke statistics-2017 update: a report from the American Heart Association", Circulation, 135, pp.e146~e603 (2017)[DOI]
  13. Gage BF, "Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation", JAMA, 285, pp.2864~2870 (2001)[DOI]
  14. Lip GY, "Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the Euro heart survey on atrial fibrillation", Chest, 137, pp.263~272 (2010)[DOI]
  15. Singer DE, "A new risk scheme to predict ischemic stroke and other thromboembolism in atrial fibrillation: the ATRIA study stroke risk score", J Am Heart Assoc, 2, pp.e000250~ (2013)
  16. Gurol ME, "Secondary stroke prevention in atrial fibrillation: new insights into an old problem", Stroke, 49, pp.1315~1317 (2018)[DOI]
  17. Sanna T, "Cryptogenic stroke and underlying atrial fibrillation", N Engl J Med, 370, pp.2478~2486 (2014)[DOI]
  18. Rogers JD, "In-office insertion of a miniaturized insertable cardiac monitor: results from the Reveal LINQ In-Office 2 randomized study", Heart Rhythm, 14, pp.218~224 (2017)[DOI]
  19. Ziegler PD, "Long-term detection of atrial fibrillation with insertable cardiac monitors in a real-world cryptogenic stroke population", Int J Cardiol, 244, pp.175~179 (2017)[DOI]
  20. Hart RG, "Rivaroxaban for stroke prevention after embolic stroke of undetermined source", N Engl J Med (2018)[DOI]
  21. Hart RG, "Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation", Ann Intern Med, 146, pp.857~867 (2007)[DOI]
  22. Aguilar MI, "Oral anticoagulants versus antiplatelet therapy for preventing stroke in patients with non-valvular atrial fibrillation and no history of stroke or transient ischemic attacks", Cochrane Database Syst Rev, 3 (2007)
  23. Ruff CT, "Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials", Lancet, 383, pp.955~962 (2014)[DOI]
  24. Connolly SJ, "Dabigatran versus warfarin in patients with atrial fibrillation", N Engl J Med, 361, pp.1139~1151 (2009)[DOI]
  25. Patel MR, "Rivaroxaban versus warfarin in nonvalvular atrial fibrillation", N Engl J Med, 365, pp.883~891 (2011)[DOI]
  26. Granger CB, "Apixaban versus warfarin in patients with atrial fibrillation", N Engl J Med, 365, pp.981~992 (2011)[DOI]
  27. Giugliano RP, "Edoxaban versus warfarin in patients with atrial fibrillation", N Engl J Med, 369, pp.2093~2104 (2013)[DOI]
  28. Pollack CV Jr, "Idarucizumab for dabigatran reversal: full cohort analysis", N Engl J Med, 377, pp.431~441 (2017)[DOI]
  29. Connolly SJ, "Andexanet Alfa for acute major bleeding associated with factor Xa inhibitors", N Engl J Med, 375, pp.1131~1141 (2016)[DOI]
  30. Nielsen PB, "Effectiveness and safety of reduced dose non-vitamin K antagonist oral anticoagulants and warfarin in patients with atrial fibrillation: propensity weighted nationwide cohort study", BMJ, 356, pp.j510~ (2017)
  31. Tawfik A, "Systematic review and network meta-analysis of stroke prevention treatments in patients with atrial fibrillation", Clin Pharmacol, 8, pp.93~107 (2016)
  32. Blackshear JL, "Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation", Ann Thorac Surg, 61, pp.755~759 (1996)[DOI]
  33. Di Biase L, "Does the left atrial appendage morphology correlate with the risk of stroke in patients with atrial fibrillation? Results from a multicenter study", J Am Coll Cardiol, 60, pp.531~538 (2012)[DOI]
  34. Reddy VY, "Percutaneous left atrial appendage closure vs warfarin for atrial fibrillation: a randomized clinical trial", JAMA, 312, pp.1988~1998 (2014)[DOI]
  35. Holmes DR Jr, "Prospective randomized evaluation of the Watchman Left Atrial Appendage Closure device in patients with atrial fibrillation versus long-term warfarin therapy: the PREVAIL trial", J Am Coll Cardiol, 64, pp.1~12 (2014)[DOI]
  36. Reddy VY, "Post-approval U.S. experience with left atrial appendage closure for stroke prevention in atrial fibrillation", J Am Coll Cardiol, 69, pp.253~261 (2017)
  37. Tzikas A, "Left atrial appendage occlusion for stroke prevention in atrial fibrillation: multicentre experience with the AMPLATZER Cardiac Plug", EuroIntervention, 11, pp.1170~1179 (2016)[DOI]
  38. Bartus K, "Anatomic analysis of the left atrial appendage after closure with the LARIAT device", Circ Arrhythm Electrophysiol, 7, pp.764~767 (2014)[DOI]
  39. Ailawadi G, "Exclusion of the left atrial appendage with a novel device: early results of a multicenter trial", J Thorac Cardiovasc Surg, 142, pp.1002~1009 (2011)[DOI]
  40. Furlan AJ, "Closure or medical therapy for cryptogenic stroke with patent foramen ovale", N Engl J Med, 366, pp.991~999 (2012)[DOI]
  41. Meier B, "Percutaneous closure of patent foramen ovale in cryptogenic embolism", N Engl J Med, 368, pp.1083~1091 (2013)[DOI]
  42. Hagen PT, "Incidence and size of patent foramen ovale during the first 10 decades of life: an autopsy study of 965 normal hearts", Mayo Clin Proc, 59, pp.17~20 (1984)[DOI]
  43. Kerut EK, "Patent foramen ovale: a review of associated conditions and the impact of physiological size", J Am Coll Cardiol, 38, pp.613~623 (2001)[DOI]
  44. Tobe J, "Transcranial Doppler is complementary to echocardiography for detection and risk stratification of patent foramen ovale", Can J Cardiol, 32, pp.986~ (2016)
  45. Evers S, "Cerebrovascular ischemic events in wind instrument players", Neurology, 55, pp.865~867 (2000)[DOI]
  46. Cramer SC, "Increased pelvic vein thrombi in cryptogenic stroke: results of the Paradoxical Emboli from Large Veins in Ischemic Stroke (PELVIS) study", Stroke, 35, pp.46~50 (2004)
  47. Wells PS, "Diagnosis of venous thromboembolism: 20 years of progress", Ann Intern Med, 168, pp.131~140 (2018)[DOI]
  48. Connors JM, "Thrombophilia testing and venous thrombosis", N Engl J Med, 377, pp.1177~1187 (2017)[DOI]
  49. Isayev Y, ""Economy class" stroke syndrome?", Neurology, 58, pp.960~961 (2002)[DOI]
  50. Homma S, "Effect of medical treatment in stroke patients with patent foramen ovale: patent foramen ovale in Cryptogenic Stroke Study", Circulation, 105, pp.2625~2631 (2002)[DOI]
  51. Ntaios G, "Closure of patent foramen ovale versus medical therapy in patients with cryptogenic stroke or transient ischemic attack: updated systematic review and meta-analysis", Stroke, 49, pp.412~418 (2018)[DOI]
  52. Niu X, "Closure of patent foramen ovale for cryptogenic stroke patients: an updated systematic review and meta-analysis of randomized trials", J Neurol (2018)[DOI]
  53. Ando T, "Meta-analysis comparing patent foramen ovale closure versus medical therapy to prevent recurrent cryptogenic stroke", Am J Cardiol, 121, pp.649~655 (2018)[DOI]
  54. Powers WJ, "2018 Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association", American Stroke Association, 2018, pp.49, e46~e110
  55. Dellborg M, "Randomized trials of closure of persistent foramen ovale (PFO) vs medical therapy for patients with cryptogenic stroke: effect of lost-to-follow-up and withdrawal of consent", Int J Cardiol, 207, pp.308~309 (2016)[DOI]
  56. Martin F, "Percutaneous transcatheter closure of patent foramen ovale in patients with paradoxical embolism", Circulation, 106, pp.1121~1126 (2002)[DOI]
  57. Holland TL, "Infective endocarditis", Nat Rev Dis Primers, 2, pp.16059~ (2016)[DOI]
  58. Habib G, "2015 ESC guidelines for the management of infective endocarditis: the task force for the management of infective endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM)", Eur Heart J, 36, pp.3075~3128 (2015)[DOI]
  59. Champey J, "Value of brain MRI in infective endocarditis: a narrative literature review", Eur J Clin Microbiol Infect Dis, 35, pp.159~168 (2016)[DOI]
  60. Baddour LM, "Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications. A scientific statement for healthcare professionals from the American Heart Association", Circulation, 132, pp.1435~1486 (2015)[DOI]
  61. Chakraborty T, "Utility of brain magnetic resonance imaging in the surgical management of infective endocarditis", J Stroke Cerebrovasc Dis, 26, pp.2527~2535 (2017)[DOI]
  62. Duval X, "Effect of early cerebral magnetic resonance imaging on clinical decisions in infective endocarditis: a prospective study", Ann Intern Med, 152, pp.497~504 (2010)[DOI]
  63. Singhal AB, "Acute ischemic stroke patterns in infective and nonbacterial thrombotic endocarditis: a diffusion-weighted magnetic resonance imaging study", Stroke, 33, pp.1267~1273 (2002)[DOI]
  64. Brownlee WJ, "Intravenous thrombolysis is unsafe in stroke due to infective endocarditis", Intern Med J, 44, pp.195~197 (2014)[DOI]
  65. Scharf EL, "Endovascular management of cerebral septic embolism: three recent cases and review of the literature", J Neurointerv Surg, 9, pp.463~465 (2017)[DOI]
  66. Garcia-Cabrera E, "Neurological complications of infective endocarditis: risk factors, outcome, and impact of cardiac surgery: a multicenter observational study", Circulation, 127, pp.2272~2284 (2013)[DOI]
  67. Graff-Radford J, "Distinguishing clinical and radiological features of non-traumatic convexal subarachnoid hemorrhage", Eur J Neurol, 23, pp.839~846 (2016)[DOI]
  68. Iung B, "Determinants of cerebral lesions in endocarditis on systematic cerebral magnetic resonance imaging: a prospective study", Stroke, 44, pp.3056~3062 (2013)[DOI]
  69. Cooper HA, "Subclinical brain embolization in left-sided infective endocarditis: results from the evaluation by MRI of the brains of patients with left-sided intracardiac solid masses (EMBOLISM) pilot study", Circulation, 120, pp.585~591 (2009)[DOI]
  70. Okazaki S, "Cerebral microbleeds predict impending intracranial hemorrhage in infective endocarditis", Cerebrovasc Dis, 32, pp.483~488 (2011)[DOI]
  71. Allen LM, "Retrospective review of cerebral mycotic aneurysms in 26 patients: focus on treatment in strongly immunocompromised patients with a brief literature review", AJNR Am J Neuroradiol, 34, pp.823~827 (2013)[DOI]
  72. Ducruet AF, "Intracranial infectious aneurysms: a comprehensive review", Neurosurg Rev, 33, pp.37~46 (2010)[DOI]
  73. Yoon NK, "Imaging of cerebral aneurysms: a clinical perspective", Neurovasc Imaging, 2, pp.1~7 (2016)[DOI]
  74. Kannoth S, "Intracranial microbial aneurysm (infectious aneurysm): current options for diagnosis and management", Neurocrit Care, 11, pp.120~129 (2009)[DOI]
  75. Kannoth S, "Proposed diagnostic criteria for intracranial infectious aneurysms", J Neurol Neurosurg Psychiatry, 79, pp.943~946 (2008)[DOI]
  76. Woohyeun Kim, "Heart Failure as a Risk Factor for Stroke", 대한뇌졸중영문학회지, 20(1), pp.33~45 (2018), 대한뇌졸중학회[DOI]
  77. Abdul-Rahim AH, "Risk of stroke in chronic heart failure patients without atrial fibrillation: analysis of the Controlled Rosuvastatin in Multinational Trial Heart Failure (CORONA) and the Gruppo Italiano per lo Studio della Sopravvivenza nell'Insufficienza Cardiaca-Heart Failure (GISSI-HF) trials", Circulation, 131, pp.1486~1494 (2015)[DOI]
  78. Homma S, "Warfarin and aspirin in patients with heart failure and sinus rhythm", N Engl J Med, 366, pp.1859~1869 (2012)[DOI]
  79. Cook JL, "Recommendations for the use of mechanical circulatory support: ambulatory and community patient care. A scientific statement from the American Heart Association", Circulation, 135, pp.e1145~e1158 (2017)[DOI]
  80. Mehra MR, "A fully magnetically levitated circulatory pump for advanced heart failure", N Engl J Med, 376, pp.440~450 (2017)[DOI]
  81. Cannegieter SC, "Thromboembolic and bleeding complications in patients with mechanical heart valve prostheses", Circulation, 89, pp.635~641 (1994)[DOI]
  82. Murthy SB, "Restarting anticoagulant therapy after intracranial hemorrhage: a systematic review and meta-analysis", Stroke, 48, pp.1594~1600 (2017)[DOI]
  83. Snipelisky D, "Current strategies to minimize the bleeding risk of warfarin", J Blood Med, 4, pp.89~99 (2013)
  84. Heneghan CJ, "Self-monitoring and self-management of oral anticoagulation", Cochrane Database Syst Rev, 7 (2016)
  85. Kajermo U, "Incidence, trends, and predictors of ischemic stroke 30 days after an acute myocardial infarction", Stroke, 45, pp.1324~1330 (2014)[DOI]
  86. Hachet O, "Frequency and predictors of stroke after acute myocardial infarction: specific aspects of in-hospital and postdischarge events", Stroke, 45, pp.3514~3520 (2014)[DOI]
  87. Levine GN, "2016 ACC", AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease: a report of the American College of Cardiology, J Am Coll Cardiol, pp.2016, 68[DOI]
  88. Gibson CM, "Prevention of bleeding in patients with atrial fibrillation undergoing PCI", N Engl J Med, 375, pp.2423~2434 (2016)[DOI]
  89. Cannon CP, "Dual antithrombotic therapy with dabigatran after PCI in atrial fibrillation", N Engl J Med, 377, pp.1513~1524 (2017)[DOI]
  90. Eikelboom JW, "Rivaroxaban with or without aspirin in stable cardiovascular disease", N Engl J Med, 377, pp.1319~1330 (2017)[DOI]

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