Atrial Fibrillation in Embolic Stroke: Anticoagulant Therapy at UNTH, Enugu

Objective: The decision to commence anticoagulation in a patient with embolic stroke and atrial fibrillation (AF) is often a difficult one for many clinicians. The result can have significant impact on the patient. This study was therefore undertaken to review the use of anticoagulation in embolic stroke in the setting of atrial fibrillation at the UNTH Enugu. Method: Records of patients managed for embolic stroke at the University of Nigeria Teaching Hospital Enugu in a total study period of 20 years (1980 - 1999) were retrospectively studied. Data was collected from patients' case records using a proforma that had been specifically designed for the study. Results: Twenty three patients with embolic stroke were reviewed. Nine patients had atrial fibrillation as risk factor of which six patients received anticoagulation for secondary prophylaxis of embolic stroke. A greater fraction of requiring males received anticoagulation than that in requiring females. All the patients that were anticoagulated were lost to follow-up. Conclusion: This study shows a considerable willingness in physicians to commence anticoagulation in the setting of embolic stroke with concurrent atrial fibrillation. Efforts should be made to enhance physician confidence and attitude towards appropriate anticoagulation where required. Measures to encourage adequate follow-up of patients are required. Key Words: Atrial fibrillation, embolic stroke, anticoagulation Orient Journal of Medicine Vol.16(3&4) 2004: 14-17