Generation X – Challenges in Anticoagulation!

Abstract

Atrial fibrillation (AF) increases an individual's risk of stroke by 4 to 6 times on average. The risk increases with age. In people over 80 years old, AF is the direct cause of 1 in 4 strokes. In these cases, anticoagulation therapy is recommended for primary prevention and secondary stroke prevention. Direct oral anticoagulants (DOACs) such asRivaroxaban are preferred over Vitamin K antagonists (VKA), according to the latest guidelines. To present interesting and challenging cases from the clinical practice and discuss use of Rivaroxaban in primary and secondary prevention in patients with AF and stroke.In November 2022 we organized a two-day workshop, under the auspices of the pharma company Bayer d.o.o. Ljubljana-Representative Office Skopje, Macedonia. Neurology and Cardiology residents presented 10 clinical cases, under the mentorship of respective specialists, experts in their fields. Clinical features, laboratory analysis, neuroimaging findings and contemporary management of each case were discussed in detail. Designated mentors presented the latest guidelines and recommendations regarding use of Rivaroxaban in primary and secondary prevention in patients with AF and stroke.Below we present 10 clinical cases and describe in detail their physical and neurological condition, laboratory and imaging findings and therapeutic approach.