Antithrombotic Therapy To Prevent Stroke in Patients with Atrial Fibrillation

Letters16 May 2000Antithrombotic Therapy To Prevent Stroke in Patients with Atrial FibrillationRobert G. Hart, MD and Lesly A. Pearce, MSRobert G. Hart, MDUniversity of Texas; San Antonio, TX 78284 (Hart)Axio Research Corp.; Seattle, WA 98121 (Pearce) and Lesly A. Pearce, MSUniversity of Texas; San Antonio, TX 78284 (Hart)Axio Research Corp.; Seattle, WA 98121 (Pearce)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-132-10-200005160-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Thanks to Dr. Singer for pointing out a misleading heading in Table 2 of our meta-analysis: "Control group" was inadvertently changed to "placebo group" in the process of revision.Dr. Singer's lack of enthusiasm for aspirin use in atrial fibrillation is long-standing and often voiced (1, 2). His current concerns appear based on post hoc exploratory subgroup analyses of SPAF I, which are not relevant to our meta-analysis. To date, all six randomized trials (five of them double-blind) have shown trends toward reduction in stroke with aspirin use in patients with atrial fibrillation (see the Figure in our ...References1. Singer DE, Hughes RA, Gress DR. The effect of aspirin on the risk of stroke in patients with nonrheumatic atrial fibrillation: the BAATAF Study. Am Heart J. 1992;124:1567-73. CrossrefMedlineGoogle Scholar2. Singer DE. Aspirin and prevention [Letter]. Lancet. 1994;343:233-4. CrossrefMedlineGoogle Scholar3. Gullov AL, Koefoed BG, Petersen P, Pedersen TS, Andersen ED, Godtfredsen J, et al . Fixed mini-dose warfarin and aspirin alone and in combination vs. adjusted-dose warfarin for stroke prevention in atrial fibrillation: Second Copenhagen Atrial Fibrillation, Aspirin, and Anticoagulation Study. Arch Intern Med. 1998;158:1513-21. CrossrefMedlineGoogle Scholar4. Hellemons BS, Langenberg M, Lodder J, Vermeer F, Schouten HJ, Lemmens T, et al . Primary prevention of arterial thromboembolism in nonrheumatic atrial fibrillation in primary care: randomised controlled trial comparing two intensities of coumarin with aspirin. BMJ. 1999;319:958-64. CrossrefMedlineGoogle Scholar5. The SPAF III Writing Committee for the Stroke Prevention in Atrial Fibrillation Investigators. Patients with nonvalvular atrial fibrillation at low risk of stroke during treatment with aspirin. JAMA. 1998;279:1273-7. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Robert G. Hart, MD; Lesly A. Pearce, MSAffiliations: University of Texas; San Antonio, TX 78284 (Hart)Axio Research Corp.; Seattle, WA 98121 (Pearce) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAntithrombotic Therapy To Prevent Stroke in Patients with Atrial Fibrillation Robert G. Hart , Oscar Benavente , Ruth McBride , and Lesly A. Pearce Antithrombotic Therapy To Prevent Stroke in Patients with Atrial Fibrillation Daniel E. Singer Metrics 16 May 2000Volume 132, Issue 10Page: 841-842KeywordsAspirinAtrial fibrillationRandomized trialsStroke ePublished: 15 August 2000 Issue Published: 16 May 2000 Copyright & PermissionsCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...