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Anticoagulation in patients at high risk of stroke without documented atrial fibrillation. Time for a paradigm shift?

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dc.contributor.author Bayés de Luna, A.
dc.contributor.author Baranchuk, Adrian
dc.contributor.author Martínez Sellés Oliveria Soares, Manuel
dc.contributor.author Platonov, Pyotr G.
dc.date.accessioned 2018-05-10T15:59:07Z
dc.date.available 2018-05-10T15:59:07Z
dc.date.issued 2017
dc.identifier.citation Bayés de Luna, A., Baranchuk, A., Martínez‐Sellés, M., & Platonov, P. G. (2017). Anticoagulation in patients at high risk of stroke without documented atrial fibrillation. Time for a paradigm shift?. Annals of Noninvasive Electrocardiology, 22(1). DOI: 10.1111/anec.12417 spa
dc.identifier.issn 1082-720X
dc.identifier.issn 1542-474X
dc.identifier.uri http://hdl.handle.net/11268/7249
dc.description.abstract Atrial fibrillation (AF) is currently considered a risk factor for stroke. Depending on the severity of clinical factors (risk scores) a recommendation for full anticoagulation is made. Although AF is most certainly a risk factor for ischemic stroke, it is not necessarily the direct cause of it. The causality of association between AF and ischemic stroke is questioned by the reported lack of temporal relation between stroke events and AF paroxysms (or atrial high-rate episodes detected by devices). In different studies, only 2% of patients had subclinical AF > 6 minutes in duration at the time of stroke or systemic embolism. Is it time to consider AF only one more factor of endothelial disarray rather than the main contributor to stroke? In this "opinion paper" we propose to consider not only clinical variables predicting AF/stroke but also electrocardiographic markers of atrial fibrosis, as we postulate this as a strong indicator of risk of AF/stroke. We ask if it is time to change the paradigm and to consider, in some special situations, to protect patients (preventing stroke) who have no evidence of AF. spa
dc.description.sponsorship Sin financiación spa
dc.language.iso eng spa
dc.title Anticoagulation in patients at high risk of stroke without documented atrial fibrillation. Time for a paradigm shift? spa
dc.type article spa
dc.description.impact 1.562 JCR (2017) Q3, 91/128 Cardiac and Cardiovascular Systems spa
dc.identifier.doi 10.1111/anec.12417
dc.rights.accessRights closedAccess spa
dc.subject.uem Anticoagulantes spa
dc.subject.uem Fibrilación auricular spa
dc.subject.uem Infarto de miocardio spa
dc.subject.unesco Enfermedad cardiovascular spa
dc.description.filiation UEM spa
dc.relation.publisherversion http://ezproxy.universidadeuropea.es/login?url=http:/ /dx.doi.org/10.1111/anec.12417 spa
dc.peerreviewed Si spa


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