engleski

WARFARIN: GOLD STANDARD OF ANTICOAGULANT THERAPY

Antithrombotic therapy is recommended for ischemic stroke prevention. Anticoagulants are most commonly used as a long term oral therapy in patients with atrial fibrillation or other cardiac condition with a high risk of embolism. Since 1950s oral anticoagulant therapy with vitamin K antagonists (warfarin) was introduced into clinical practice, and it is has been a gold standard for secondary prevention of ischemic stroke. In the last few years its role in stroke prevention in patients with nonvalvular atrial fibrillation has been weakened because of development and presence of novel oral anticoagulants (direct thrombin inhibitors and direct inhibitors of factor Xa). However, warfarin has still a leading role in stroke prevention and treatment in patients with valvular atrial fibrillation, atrial fibrillation and severe renal impairment, acute myocardial infarction with mural thrombus, cerebral venous thrombosis and acquired or inherited hypercoagulability states. The advantages, disadvantages and other indications for treatment with warfarin will be discussed.

warfarin

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