July 11, 1994Archives of Internal Medicine

Risk Factors for Stroke and Efficacy of Antithrombotic Therapy in Atrial Fibrillation

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Why the study?

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

Population

Patients with atrial fibrillation pooled from five randomized trials. Mean age 69 years, 46% had history of…

Comparison

Warfarin or Aspirin vs Control

Design

Meta-analysis

Discussion

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Implication

Warfarin is preferred for stroke prevention in AF; confirms robust efficacy over aspirin's inconsistent benefit in Level 1 evidence.

Structured PICO

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

Population

Patients with atrial fibrillation pooled from five randomized trials. Mean age 69 years, 46% had history of hypertension, 14% had diabetes.

Intervention

Warfarin (target PT ratio 1.2-1.5 to INR 2.8-4.2) or Aspirin (75 mg or 325 mg daily)

Comparator

Control (placebo for aspirin trials, control for warfarin trials)

Outcome

Ischemic stroke and major hemorrhagehard clinical

Warfarin is highly effective at reducing the risk of ischemic stroke in patients with atrial fibrillation with minimal increase in major bleeding, whereas aspirin's efficacy is less consistent.

Cite This Study

A 1994 study studied this question.

synapsesocial.com/papers/69fbd8416c3a0c248625dede https://doi.org/10.1001/archinte.1994.00420130036007

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