Anticoagulation for stroke prevention in new atrial fibrillation after coronary artery bypass graft surgery

Thrombosis Research
S SchulmanJ Delaney

Abstract

The benefit of early anticoagulation for stroke prophylaxis in atrial fibrillation after coronary artery bypass graft (CABG) surgery is uncertain. We therefore studied what proportion of ischemic strokes in patients with atrial fibrillation early after CABG surgery were potentially preventable by anticoagulation with warfarin. We reviewed medical records from 2264 patients with isolated CABG performed during a period when our institution had no policy on anticoagulation for postoperative atrial fibrillation. The outcome was ischemic stroke within 30days postoperatively and verified with computed tomography (CT) in patients with new postoperative atrial fibrillation for more than 48h. New, postoperative atrial fibrillation occurred in 403 (17.8%) of the patients and 191 of those (47.4%) were not started on warfarin at 48hours. Eight patients developed CT-verified ischemic stroke, which occurred on postoperative day 1-3 in 4 patients and in 3 patients was of the lacunar type. In two patients (stroke day 25 and day 30) warfarin could have been preventive. In another patient with onset of neurological symptoms on postoperative day 8 (4days from onset of the arrhythmia), systemic anticoagulation might have limited the severity of th...Continue Reading

References

Oct 1, 1987·The American Journal of Cardiology·G J TaylorH A Wellons
Dec 19, 2001·Annals of Internal Medicine·W H MaiselW G Stevenson
Jan 17, 2002·The New England Journal of Medicine·J P MohrUNKNOWN Warfarin-Aspirin Recurrent Stroke Study Group
Sep 23, 2003·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Giuseppe D'AnconaFrancois Dagenais
Apr 6, 2004·The Annals of Thoracic Surgery·Jarmo LahtinenTatu Juvonen
Apr 15, 2004·JAMA : the Journal of the American Medical Association·Joseph P MathewUNKNOWN Multicenter Study of Perioperative Ischemia Research Group
Jan 24, 2006·The Annals of Thoracic Surgery·Alexander KulikB-Khanh Lam
Aug 12, 2009·Journal of Pain & Palliative Care Pharmacotherapy·UNKNOWN U.S. Food and Drug Administration
Feb 19, 2011·The Canadian Journal of Cardiology·L Brent Mitchell, UNKNOWN CCS Atrial Fibrillation Guidelines Committee
Sep 14, 2012·Annals of Thoracic and Cardiovascular Surgery : Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia·Mitsumasa HataMotomi Shiono
Sep 3, 2013·The New England Journal of Medicine·John W EikelboomUNKNOWN RE-ALIGN Investigators
Jul 23, 2014·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Richard WhitlockSalim Yusuf
Aug 15, 2014·JAMA : the Journal of the American Medical Association·Gino GialdiniHooman Kamel

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Citations

Oct 11, 2016·The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland·Ana-Catarina Pinho-Gomes, David P Taggart
Feb 17, 2017·Cerebrovascular Diseases·Leila H BorowskyDaniel E Singer
Sep 1, 2017·European Stroke Journal·Vincent ThijsHein Heidbuchel

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