Enteric-coated acetylsalicylic acid plus dipyridamole compared with anticoagulants in the prevention of ischemic events in patients with transient ischemic attacks

Amaurosis Fugax Caused by Heritable Thrombophilia-Hypofibrinolysis in Cases Without Carotid Atherosclerosis

“…Beyond carotid artery surgery, medical therapy has included fibrinolysis, 11 anticoagulants, [12][13][14] and antiplatelet agents. 12,14,15 As in the current report, antiplatelet agents lack efficacy in the presence of heritable thrombophilias, 9,13,16 which include G1691A factor V Leiden, high factor VIII, [17][18][19][20] familial protein S deficiency, C677T methylenetetrahydrofolate reductase (MTHFR) homozygosity, and C677T-A1298C MTHFR compound heterozygosity. 21 Instead, therapy must be based on low-molecular-weight heparin (short-term), Coumadin (long-term; Bristol-Myers Squibb, New York, NY), and folic acid, vitamin B6, and vitamin B12 for MTHFR-homocysteine disorders.…”

“…21 The association of inherited thrombophilias with AF is not surprising because thrombophilias cause retinal artery thrombosis 16 and nonarteritic ischemic optic neuropathy. 22,23 We speculated that thromboprophylaxis in patients with AF associated with heritable thrombophilia-hypofibrinolysis may help to prevent the otherwise high risk of later development of AF and reduce the risk for retinal artery thrombosis, transient cerebral ischemic attacks, or ischemic strokes, [11][12][13][14][15]24 for which AF is a predictive forerunner. 1,2,4,5,8…”