Key result
Warfarin reduces stroke and systemic embolism by an absolute ~1.2% versus aspirin in elderly AF.
Why the study?
There is controversy and apprehension regarding the routine use of oral anticoagulants in atrial fibrillation, especially in elderly people.
Does prophylactic anticoagulant therapy prevent embolic stroke in older people with non-rheumatic atrial fibrillation?
Population
Older people with non-rheumatic atrial fibrillation
Comparison
Prophylactic warfarin vs aspirin if unable to tolerate warfarin
Design
Editorial review
Authors
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Supports anticoagulation for stroke prevention in eligible non-rheumatic AF; leaves open optimal strategies for elderly patients with contemporary agents.
Does prophylactic anticoagulant therapy prevent embolic stroke in older people with non-rheumatic atrial fibrillation?
Absolute Risk Reduction: 1.2
Absolute Risk Reduction: 1.2%
Prophylactic anticoagulation with warfarin (or aspirin if intolerant) is recommended for stroke prevention in older patients with non-rheumatic atrial fibrillation, rather than waiting for a transient ischemic attack or stroke to occur.
Gupta et al. (1999) conducted an editorial in Non-rheumatic atrial fibrillation. Warfarin vs. Aspirin or placebo was evaluated on Ischaemic stroke and systemic embolism (ARR 1.2%). Warfarin is more effective than aspirin for preventing stroke in non-rheumatic atrial fibrillation, reducing the absolute risk of ischaemic stroke and systemic embolism by 1.2% in patients over 75 years.
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