What question did this study set out to answer?

The aim is to assess the effectiveness and safety of anticoagulants and antiplatelet agents in preventing strokes in patients with atrial fibrillation.

October 5, 1999Annals of Internal Medicine

Antithrombotic Therapy To Prevent Stroke in Patients with Atrial Fibrillation

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Why the study?

Does antithrombotic therapy (warfarin or aspirin) reduce stroke in patients with atrial fibrillation?

Key Points

The aim is to assess the effectiveness and safety of anticoagulants and antiplatelet agents in preventing strokes in patients with atrial fibrillation.
Analyzed data from 16 randomized trials involving 9874 participants.
Evaluated the efficacy of adjusted-dose warfarin and aspirin in reducing stroke occurrences and major bleeding.
Results were compared to determine the relative risk reduction and absolute risk reductions for stroke.
Adjusted-dose warfarin reduced stroke by 62% (95% CI, 48% to 72%) with an absolute risk reduction of 2.7% per year for primary prevention.
Aspirin reduced stroke by 22% (CI, 2% to 38%) with an absolute risk reduction of 1.5% per year for primary prevention.
Warfarin was significantly more effective than aspirin, showing a 36% relative risk reduction (CI, 14% to 52%).

Structured PICO

Does antithrombotic therapy (warfarin or aspirin) reduce stroke in patients with atrial fibrillation?

Population

9,874 patients with atrial fibrillation pooled from 16 randomized trials

Intervention

Antithrombotic therapy (adjusted-dose warfarin or aspirin)

Comparator

Placebo/control or active comparator (warfarin vs aspirin)

Outcome

All stroke (ischemic and hemorrhagic)hard clinical

Adjusted-dose warfarin and aspirin both reduce stroke risk in patients with atrial fibrillation, with warfarin being substantially more efficacious than aspirin.

Discussion

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Implication

Warfarin should be preferred over aspirin for stroke prevention in eligible AF patients; reinforces consensus from randomized trials and guides comparisons with newer agents.

Cite This Study

Hart et al. (1999) studied this question.

synapsesocial.com/papers/69fbd8416c3a0c248625deda https://doi.org/10.7326/0003-4819-131-7-199910050-00003

Topics

Atrial fibrillation Persistent AF management Anticoagulation in AF Dual antiplatelet therapy

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Implication

Warfarin should be preferred over aspirin for stroke prevention in eligible AF patients; reinforces consensus from randomized trials and guides comparisons with newer agents.

Antithrombotic Therapy To Prevent Stroke in Patients with Atrial Fibrillation

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Antithrombotic Therapy To Prevent Stroke in Patients with Atrial Fibrillation

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

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