Key result
Warfarin use in AF patients with previous ICH had favorable net benefit for those with CHA2DS2-VASc ≧6, with an NNT of 37 for preventing ischemic stroke versus an NNH of 56 for causing ICH.
Why the study?
Does warfarin or antiplatelet therapy reduce ischemic stroke without excessive intracranial hemorrhage in patients with atrial fibrillation and a history of ICH compared to no treatment?
Population
12,917 patients with atrial fibrillation, a CHA2DS2-VASc score ≧2, and a history of intracranial hemorrhage
Comparison
Warfarin or antiplatelet therapy vs No antithrombotic treatment
Design
Cohort
Authors
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May support warfarin net benefit in AF with prior ICH and CHA2DS2-VASc ≥6; hypothesis-generating, needs randomized confirmation.
Cohort (n=12,917)
Does warfarin or antiplatelet therapy reduce ischemic stroke without excessive intracranial hemorrhage in patients with atrial fibrillation and a history of ICH compared to no treatment?
Number Needed to Treat: 37
Absolute Event Rate: 3.4% vs 5.8%
Number Needed to Treat: 37
Warfarin may provide a net clinical benefit for stroke prevention in atrial fibrillation patients with a history of ICH only if their CHA2DS2-VASc score is ≧6.
Chao et al. (2016) conducted a cohort in Atrial fibrillation with a history of intracranial hemorrhage (n=12,917). Warfarin vs. No treatment was evaluated on Ischemic stroke. Warfarin use in AF patients with previous ICH had favorable net benefit for those with CHA2DS2-VASc ≧6, with an NNT of 37 for preventing ischemic stroke versus an NNH of 56 for causing ICH.
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