Why the study?
Warfarin is an established therapy to prevent cardioembolic stroke, but its effects on whole blood viscosity had not been studied.
Does warfarin reduce whole blood viscosity compared to aspirin in patients with non-valvular atrial fibrillation and acute cardioembolic stroke?
Population
67 patients aged 56–90 years with NVAF, CHADS2 score ≥ 2, and acute mild-to-moderate cardioembolic stroke
Comparison
Warfarin vs aspirin
Design
Single-center prospective clinical trial with alternate assignment
Key result
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.
Authors
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Warfarin was associated with greater viscosity reduction than aspirin in acute cardioembolic stroke; leaves open hemorheological mechanisms pending randomized trials.
RCT (n=67)
Open-label, blinded-endpoint
Alternately assigned
No
Does warfarin reduce whole blood viscosity compared to aspirin in patients with non-valvular atrial fibrillation and acute cardioembolic stroke?
Effect estimate: OR 3.71 (95% CI 1.04-13.17)
p-value: p=0.043
Warfarin confers greater reductions in whole blood viscosity than aspirin in patients with acute cardioembolic stroke and atrial fibrillation, suggesting a hemorheological mechanism contributing to its antithrombotic efficacy.
Lee et al. (2019) conducted an 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.