Background: Atrial fibrillation (AF) is a risk factor for stroke but, despite anticoagulation therapy, the risk of stroke is not completely eliminated. We evaluated the presence of microembolic signals (MES) by TCD emboli-monitoring in AF patients receiving various anticoagulation therapies.
Methods: In total, 103 patients were divided into four therapeutic groups (receiving warfarin, dabigatran, rivaroxaban, or apixaban; 22 patients in each group) and a control group (15 patients). Common stroke risk factors were evaluated, such arterial hypertension, ischemic heart disease, history of TIA/stroke, diabetes mellitus, and hyperlipidemia. TCD emboli-monitoring was performed on bilateral middle cerebral arteries for 45-60 minutes.
Results: No statistically significant differences were determined regarding the presence of risk factors between all groups. We found 2 MES in the warfarin group, 1 in the rivaroxaban group, 4 in the dabigatran group, and 0 in the apixaban group. One patient had positive MES in the control group. No statistical differences were seen when the groups were compared with the control group or with each other.
Conclusions: TCD emboli-monitoring can be used for MES detection in patients with AF receiving anticoagulation therapy and thus for the identification of patients at high risk of stroke occurrence/reoccurence.