Article information
Resumen
El ictus y la fibrilación auricular (FA) son una verdadera epidemia vascular y sus consecuencias son catastróficas. La complicación mas común y devastadora de la FA es el ictus cardioembólico, pero esta catástrofe es previsible y prevenible.
El diagnóstico etiológico correcto del ictus es esencial para poder realizar una prevención adecuada. Hay un porcentaje de ictus isquémicos criptogénicos demasiado elevado, y es preciso mejorar la detección de la FA y otras fuentes cardioembólicas.
La isquemia cerebral cardioembólica es prevenible; sin embargo, la inercia medica, la falta de adherencia del paciente y los problemas de los antagonistas de la vitamina K, llevan a que muchos pacientes estén en riesgo de sufrir una isquemia cerebral.
Los relevantes avances recientes con fármacos como la dronedarona y el dabigatrán e inhibidores del FXa, abren una esperanza real para mejorar su prevención, y ya se reflejan en las guías terapéuticas y, por tanto, los neurólogos los debemos conocer. El mundo vascular y la sociedad están de enhorabuena, podemos evitar mucho sufrimiento.
Palabras clave:
Ictus
Fibrilación auricular
Prevención
Dronedarona
Dabigatrán
Inhibidores FXa
Cardioembolia
Abstract
Stroke and atrial fibrillation (AF) constitute a true vascular epidemic with catastrophic consequences. The most common and devastating complication of AF is cardioembolic stroke but this catastrophic event can be predicted and prevented.
Accurate etiologic diagnosis of stroke is essential for effective prevention. The percentage of cryptogenic ischemic strokes is too high and detection of AF and other causes of cardioembolic events should be improved.
Cardioembolic cerebral ischemia can be prevented. However, because of physician inertia, lack of patient adherence and the problems of vitamin K antagonists, many patients are at risk of cerebral ischemia.
Recently, major advances with drugs such as dronedarone, dabigatran and FXa inhibitors have opened the way to improving stroke prevention, as reflected in therapeutic guidelines, and neurologists should be familiar with these drugs. There is reason to hope that much suffering can be avoided.
Keywords:
Stroke
Atrial fibrillation
Prevention
Dronedarone
Dabigatran
Fxa inhibitors
Cardioembolism
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