This site gives a short overview of interesting results from other stroke-related research projects.
2019/06/07 An integral part of the follow-up treatment of stroke patients is the secondary prophylactic medication. It is administered to prevent secondary strokes and is adjusted individually according to the patients risk profile. Patients with known atrial fibrillation will be treated according to guidelines with oral anticoagulants, meaning they will be given „blood-thinners“ in the form of tablets.
However, one group of patients is hard to categorize in this risk profile: Namely, patients with a diagnosis which points to an underlying heart condition or arrhythmia (atrial fibrillation), which however cannot be observed at the time of the stroke incident. This group is said to have an „embolic stroke of undetermined source“ (ESUS).
In two recently published studies (last of which was the RE-SPECT ESUS study, published last month) it was investigated to what extend ESUS-patients benefit from anticoagulation. More specifically the rate of secondary incidents was compared when the patient was given anticoagulants or the standard treatment, e.g. acetylsalicylic acid.
Unfortunately, no advantage could be found with the stronger „blood-thinners“. Hence, in future studies other diagnostic and treatment options have to be examined more closely. Furthermore the study shows how important follow-up treatment is for stroke patients, because a close post-incident supervision can help to identify additional risk-factors and to adjust the medication accordingly.
Reference: Diener HC, Sacco RL, Easton JD, Granger CB, Bernstein RA, Uchiyama S, Kreuzer J, Cronin L, Cotton D, Grauer C, Brueckmann M, Chernyatina M, Donnan G, Ferro JM, Grond M, Kallmünzer B, Krupinski J, Lee BC, Lemmens R, Masjuan J, Odinak M, Saver JL, Schellinger PD, Toni D, Toyoda K; RE-SPECT ESUS Steering Committee and Investigators. Dabigatran for Prevention of Stroke after Embolic Stroke of Undetermined Source. N Engl J Med 2019; 380: 1906-1917.