Anticoagulation Failure in Stroke: Causes, Risk Factors, and Treatment

Anticoagulation is crucial to reducing the risk of cardioembolic strokes, particularly in vulnerable populations such as patients with atrial fibrillation, artificial heart valves, or left ventricular thrombus. Though successful, anticoagulation failure (the occurrence of an ischemic stroke or syste...

Full description

Saved in:
Bibliographic Details
Main Authors: Youngbin Choi, Jong S. Kim
Format: Article
Language:English
Published: Korean Stroke Society 2025-05-01
Series:Journal of Stroke
Subjects:
Online Access:http://j-stroke.org/upload/pdf/jos-2025-00206.pdf
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Anticoagulation is crucial to reducing the risk of cardioembolic strokes, particularly in vulnerable populations such as patients with atrial fibrillation, artificial heart valves, or left ventricular thrombus. Though successful, anticoagulation failure (the occurrence of an ischemic stroke or systemic embolism while receiving therapy) remains a major stroke-care issue. The reason for anticoagulation failure can be below the required threshold, inability to follow up, drug-drug interactions, preexisting hypercoagulable states, or anticoagulant resistance. This failure undermines stroke prevention and requires tailored management, often requiring more drastic or alternative interventions. This review examines what drives anticoagulation failure and explores predictors of this failure in clinical, imaging, and laboratory data. It also discusses current management techniques for improving control and points to new treatments and possible futures, such as high-resolution imaging and personalized medicine based on biomarkers, to help tackle this critical clinical problem.
ISSN:2287-6391
2287-6405