Oral anticoagulation in nonvalvular atrial fibrillation.

Abstract:

:Chronic nonvalvular atrial fibrillation is associated with an overall risk of thromboembolic complications of 4.5% per year. Advancing age, prior stroke or transient cerebral ischaemia, diabetes, hypertension, and impaired function of the left ventricle are known risk factors. Placebo-controlled trials have demonstrated that oral anticoagulant therapy with warfarin is effective for primary and secondary prevention of ischaemic stroke, reducing the risk by 68%. The effect of aspirin is still controversial, reducing the risk by 18-44%. Recent clinical trials have investigated the effect of warfarin given at a very low intensity alone or combined with aspirin. The results from the SPAF III study demonstrated that a combination of mini-intensity warfarin plus aspirin was insufficient for stroke prevention in atrial fibrillation. More trials have now confirmed that oral anticoagulation at INR-values below 2.0 is not effective for prevention of thromboembolic events in these patients. It is currently recommended that patients at a high risk of stroke are treated with warfarin at an intensity of INR 2.0-3.0. Patients younger than 65 years without other risk factors can be given aspirin 325 mg day-1.

journal_name

J Intern Med

authors

Koefoed BG,Petersen P

doi

10.1046/j.1365-2796.1999.00461.x

subject

Has Abstract

pub_date

1999-04-01 00:00:00

pages

375-81

issue

4

eissn

0954-6820

issn

1365-2796

journal_volume

245

pub_type

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