What are the recommendations for patients with ischemic stroke or TIA and valvular AF?
In patients with ischemic stroke or TIA and valvular AF (moderate to severe mitral stenosis or any mechanical heart valve), warfarin is recommended to reduce the risk of recurrent stroke or TIA.452 457 In patients with a mechanical mitral valve and a history of ischemic stroke or TIA before valve replacement, aspirin (75 100 mg/d) is recommended in addition to warfarin with an INR target of 3.0 (range, 2.5 3.5) to reduce the risk of thrombosis and recurrent stroke or TIA.458,459