Prevention Strategies for Cardioembolic Stroke: Present and Future Perspectives



Giacomo Giacalone*, 1, Mohammed Abballa Abbas1, 2, Francesco Corea*, 1, 3
1 Department of Neurology, Institute of Experimental Neurology (INSPE), IRCCS San Raffaele, Milano, Italy
2 Department Neurology, Sohag University Hospital, Sohag, Egypt
3 Unità Gravi Cerebrolesioni Acquisite (UGCA) Ospedale San Giovanni Battista, Foligno, Italy


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© Giacalone et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to these authors at the GG & FC: Department Neurology, INSPE; IRCCS San Raffaele, Via Olgettina, 48, 20132 Milano, Italia; Tel: +390226432813; Fax: +390226432951; E-mail: corea.francesco@hsr.it; giacomo.giacalone@hsr.it


Abstract

Atrial fibrillation (AF) is the most common cause of cardioembolism. An update on secondary prevention strategies, used to protect patients from the risk of stroke in many common cardiac conditions, is presented in the paper. The main line of actions of stroke prevention in cardioembolism is mostly connected with antithrombotic drugs, but also other, more invasive, techniques are quickly emerging. Also the classic pharmacological prevention with coumarins may soon be overcome by new generation anticoagulants. Is an aggressive treatment of Patent Foramen Ovale (PFO) always recommended? One of the main challenges of the future years will be to understand competitiveness between old and new preventive strategies.

Keywords: Cardioembolic stroke, risk factors, secondary prevention, antithrombotic drugs, atrial fibrillation, PFO.