ReviewJournal of clinical medicine2023
Atrial Fibrillation and Ischemic Stroke despite Oral Anticoagulation.
Review in Journal of clinical medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed.
- Recurrent Stroke Following Left Atrial Appendage Closure in Patients with Breakthrough Stroke: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2026Review
- Factors associated with symptom relief and lesion formation in acute ischemic stroke and transient ischemic attack.BMC neurology · 2026Article
- Left Atrial Appendage Closure in Patients with Atrial Fibrillation and Intermediate-to-Borderline High Cardiovascular Risk: A Retrospective Propensity Match Cohort Study.Journal of cardiovascular development and disease · 2026Article
- Percutaneous Left Atrial Appendage Closure in Patients With Cardioembolic Breakthrough Stroke: An International Observational Study.European journal of neurology · 2025Observational
- Exploring Left Atrial Appendage Thrombi in Large Vessel Occlusion Stroke by Cardiac CT: Thrombus Features, LAA Characteristics and the Impact of Direct Oral Anticoagulation.Neurology international · 2025Article
- Unusual Evolution of Carotid Atherosclerosis in a Patient with Transient Ischemic Attack.Life (Basel, Switzerland) · 2025Article
- Beyond Anticoagulation: Limitations of Oral Anticoagulants in Preventing Stroke Recurrence in Atrial Fibrillation.Journal of clinical medicine · 2024Article
- Novel Anticoagulants for Stroke Prevention in Atrial Fibrillation: A Comprehensive Review.Cureus · 2024Review
- Left atrial appendage occlusion for recurrent stroke while on oral anticoagulation: a case series.European heart journal. Case reports · 2024Article
- Atrial fibrillation: stroke prevention.The Lancet regional health. Europe · 2024Review
- Assessment of Knowledge and Medication Adherence Among Patients Prescribed with Oral Anticoagulants in Atrial Fibrillation at a Tertiary Care Centre: A Cross Sectional Study.Journal of blood medicine · 2024Article
- Stroke in Patients with Atrial Fibrillation: Epidemiology, Screening, and Prognosis.Journal of clinical medicine · 2023Review
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Patients with atrial fibrillation (AF) experiencing ischemic stroke despite oral anticoagulation (OAC), i.e., breakthrough strokes, are not uncommon, and represent an important clinical subgroup in view of the consistently high risk of stroke recurrence and mortality. The understanding of the heterogenous potential mechanism underlying OAC failure is essential in order to implement specific therapeutic measures aimed at reducing the risk of recurrent ischemic stroke. However, due to the incomplete comprehension of this phenomenon and the limited available data, secondary stroke prevention in such high-risk patients represents a clinical dilemma. There are several available strategies to prevent ischemic stroke recurrence in AF patients with breakthrough stroke in the absence of competing causes unrelated to AF, and these include continuation or change in the type of OAC, addition of antiplatelet therapy, left atrial appendage closure, or any combination of the above options. However, due to the limited available data, the latest guidelines do not provide any specific recommendations about which of the above strategies may be preferred. This review describes the incidence, the clinical impact and the potential mechanisms underlying OAC failure in AF patients. Furthermore, the evidence supporting each of the above therapeutic options for secondary stroke prevention and the potential future directions will be discussed.
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