November 25, 2003JAMA
Anticoagulation Therapy for Stroke Prevention in Atrial Fibrillation
Why the study?
Does warfarin reduce the risk of thromboembolism, hemorrhage, and death in adults with nonvalvular atrial fibrillation in a usual care setting?
Population
11,526 adults with nonvalvular atrial fibrillation and no known contraindications to anticoagulation at…
Comparison
Warfarin therapy vs No warfarin therapy
Design
Cohort
Follow-up
25,341 person-years of follow-up
Authors
Discussion
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Member takes
Implication
May support warfarin consideration for thromboembolism prevention in nonvalvular AF; extends trial data to real-world usual care while leaving net benefit open.
Structured PICO
Does warfarin reduce the risk of thromboembolism, hemorrhage, and death in adults with nonvalvular atrial fibrillation in a usual care setting?
P
Population
11,526 adults with nonvalvular atrial fibrillation and no known contraindications to anticoagulation at baseline (from a total cohort of 13,559), mean age 71 years, 43% women, in a large integrated health care system in Northern California.
I
Intervention
Warfarin therapy
C
Comparator
No warfarin therapy (either no antithrombotic therapy or aspirin)
O
Outcome
Ischemic stroke, peripheral embolism, hemorrhage, and deathhard clinical
Warfarin is highly effective for preventing ischemic stroke and reducing mortality in real-world patients with nonvalvular atrial fibrillation, with only a small absolute increase in intracranial hemorrhage.
Cite This Study
Go et al. (2003) studied this question.