Does a Rationale Exist for the Use of Oral Anticoagulants in Stroke Patients?
The clinical effectiveness of oral anticoagulants for a variety of indications mostly concerns systemic disorders. In general, two levels of anticoagulant intensity have been compared in patients with venous thrombosis or with arterial diseases or mechanical heart valves. These studies have shown that a less intense regimen (INR 2.0-3.0) is as effective and safer as a high-intensity one (INR 3.0^.5). Oral anticoagulants are effective: (1) in the primary and secondary prevention of venous thromboembolism; (2) in the prevention of acute myocardial infarction in patients with arterial disease; (3) in the prevention of systemic arterial embolism in patients with tissue or mechanical prosthetic heart valves, and (4) in the prevention of stroke, recurrent infarction, and death in patients with acute myocardial infarction. Treatment with oral anticoagulants is effective in the primary prevention of embolism in patients with valvular heart disease or dilated cardiomyopathy (DUT and PE) to prev
