Anticoagulation strategy in patients with atrial fibrillation after carotid endarterectomy

Ugurlucan M., Akay H. T., Erdinc I., Oztas D. M., Conkbayir C., Aslim E., ...Daha Fazla

ACTA CHIRURGICA BELGICA, cilt.119, sa.4, ss.209-216, 2019 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 119 Sayı: 4
  • Basım Tarihi: 2019
  • Doi Numarası: 10.1080/00015458.2018.1497569
  • Dergi Adı: ACTA CHIRURGICA BELGICA
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.209-216
  • Anahtar Kelimeler: Carotid endarterectomy, atrial fibrillation, anticoagulation, TRANSIENT ISCHEMIC ATTACK, INDEPENDENT RISK-FACTOR, ANTITHROMBOTIC THERAPY, ARTERY STENOSIS, FOCUSED UPDATE, STROKE, PREVENTION, MANAGEMENT, DISEASE, ASPIRIN
  • İstanbul Üniversitesi Adresli: Evet

Özet

Aim: Carotid artery stenosis and atrial fibrillation are diseases of the aging patient population. Literature lacks precise anticoagulation treatment protocols for patients with atrial fibrillation following carotid endarterectomy. We present our experiences with anticoagulation strategy in this particular patient population.Patients and methods: Between June 2001-September 2017, 165 patients with chronic or paroxysmal atrial fibrillation out of 1594 cases from three different institutions whom received Coumadin and aspirin and required carotid endarterectomy were reviewed, respectively. Mean age was 63.47.9 years. Male/female ratio was 102/63. There were 67 diabetic and 138 hypertensive cases.Results: Patients are followed a mean of 64.4 +/- 16.9 months. Early mortality occurred in two patients due to intracranial bleeding and heart failure. Another patient was lost due to intracerebral hemorrhage and 16 other patients died due to various causes in the late follow-up. Three patients required exploration against bleeding.Conclusion: Combination of warfarin with an aim to keep the INR value between 2 and 3, and aspirin at a dosage of 100mg per day seemed feasible and in our modest patient cohort. Further studies including multicenter larger data are warranted in order to establish a precise anticoagulation treatment protocol for patients with atrial fibrillation after carotid endarterectomy.