Key result
Low-intensity warfarin (INR 1.5-2.1) was safer than conventional-intensity therapy for secondary stroke prevention in NVAF, with fewer major hemorrhages (0% vs 6.6% per year, P=0.01).
Why the study?
Does low-intensity warfarin therapy reduce major hemorrhagic complications and prevent recurrent ischemic stroke compared to conventional-intensity warfarin in patients with NVAF and prior stroke or TIA?
Population
115 patients with nonvalvular atrial fibrillation aged <80 years who had a prior stroke or transient…
Comparison
Low-intensity warfarin therapy vs Conventional-intensity warfarin therapy
Design
RCT, Randomly allocated
Follow-up
658+/-423 days
Authors
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Supports de-escalation to low-intensity warfarin for NVAF secondary prevention; challenges conventional higher INR targets in guidelines.
RCT (n=115)
Randomized
Yes
Does low-intensity warfarin therapy reduce major hemorrhagic complications and prevent recurrent ischemic stroke compared to conventional-intensity warfarin in patients with NVAF and prior stroke or TIA?
Absolute Event Rate: 0% vs 6.6%
p-value: p=0.01
Low-intensity warfarin (INR 1.5-2.1) significantly reduces major bleeding risk without increasing recurrent ischemic stroke compared to conventional-intensity warfarin (INR 2.2-3.5) for secondary prevention in NVAF.
Takenori Yamaguchi (2000) conducted an RCT in Nonvalvular atrial fibrillation with prior stroke or TIA (n=115). Low-intensity warfarin vs. Conventional-intensity warfarin (INR 2.2 to 3.5) was evaluated on Annual rate of major hemorrhagic complications (p=0.01). Low-intensity warfarin (INR 1.5-2.1) was safer than conventional-intensity therapy for secondary stroke prevention in NVAF, with fewer major hemorrhages (0% vs 6.6% per year, P=0.01).
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