Warfarin significantly increased the odds of reducing whole blood viscosity by more than 1 cP at a shear rate of 300/s compared to aspirin (OR 3.71) in patients with acute cardioembolic stroke and non-valvular atrial fibrillation.
RCT (n=67)
Open-label, blinded-endpoint
Alternately assigned
No
Effect estimate: OR 3.71 (95% CI 1.04-13.17)
p-value: p=0.043
Warfarin is evidence-based therapy for the prevention of cardioembolic stroke, but has not been studied for its effects on whole blood viscosity (WBV). This study investigated the effect of warfarin versus aspirin on WBV in patients presenting with non-valvular atrial fibrillation (NVAF) and acute cardioembolic stroke. We enrolled patients with acute cerebral infarction, aged 56–90 years who had NVAF, CHADS2 score ≥ 2, presenting with mild-to-moderate stroke (National Institute of Health Stroke Scale (NIHSS) score < 20 and modified Rankin Scale (2mRS) score < 4) in a single center. The patients were alternately assigned to warfarin or aspirin groups. Post-treatment WBV was assessed after international normalized ratio (INR) reached target range 2, 3 for patients in the warfarin group, and 5 days after baseline in the aspirin group. Total 67 patients were included, and 56 completed this study (33 warfarin and 23 aspirin). Compared to baseline values, warfarin reduced post-treatment BV at all shear rates. The BV reductions greater than 1 cP measured at shear rates of 300, 150, 5, and 1 s− 1 were independently and significantly associated with warfarin treatment compared to aspirin after adjusting for age, sex, CHA2DS2-VASc scores, and baseline hematocrit. Warfarin confers greater reductions in BV than aspirin in patients with acute cardioembolic stroke. BV could be a useful method to estimate thrombotic risk in patients receiving warfarin. KCT0001291 , Date of Registration: 2014-12-01
Lee et al. (Wed,) conducted a rct in Acute cardioembolic stroke with non-valvular atrial fibrillation (n=67). Warfarin vs. Aspirin was evaluated on Blood viscosity decrease > 1 cP at shear rate of 300/s (OR 3.71, 95% CI 1.04-13.17, p=0.043). Warfarin significantly increased the odds of reducing whole blood viscosity by more than 1 cP at a shear rate of 300/s compared to aspirin (OR 3.71) in patients with acute cardioembolic stroke and non-valvular atrial fibrillation.