RSS Feeds
Stroke Prevention in Nonvalvular Atrial Fibrillation
- Gregory W. Albers, MD;
- J. Edwin Atwood, MD;
- Jack Hirsh, MD;
- David G. Sherman, MD;
- Robert A. Hughes, MD; and
- Stuart J. Connolly, MD
Abstract
▪ There has been considerable uncertainty about the best way to prevent stroke in patients with nonvalvular atrial fibrillation. Recent studies have suggested that low-dose warfarin therapy, in addition to producing fewer bleeding complications, may be as effective as higher-dose therapy in preventing thromboembolic events. Four large, prospective, randomized trials have examined the risks and benefits of warfarin therapy for stroke prophylaxis in patients with nonvalvular atrial fibrillation. All four studies showed a substantially reduced incidence of stroke and a low incidence of significant bleeding in patients treated with warfarin. One of these studies also showed that aspirin reduced the incidence of stroke. The benefits associated with long-term low-dose warfarin therapy appear to exceed the risks for serious bleeding in most patients with atrial fibrillation. Aspirin may be a viable therapeutic option for patients who are unable to take warfarin or for those in subgroups at a low risk for stroke.
Article and Author Information
-
This manuscript represents edited transcripts from a symposium held at Stanford University Medical Center on 1 November 1990. Presentation of the Boston Area Anticoagulation Trial for Atrial Fibrillation (BAATAF) at the symposium was made by J. Philip Kistler, MD (Principal Investigator of the BAATAF study), and the summary of the BAATAF study for this manuscript was written by Dr. Robert Hughes.
-
Authors who wish to cite a section of the conference and specifically indicate its author may use this example for the form of reference:
Hirsh J. Low-dose oral anticoagulants, pp. 728-729. In: Albers G, moderator. Stroke prevention in nonvalvular atrial fibrillation. Ann Intern Med. 1991;115:727-736.
-
Grant Support: The symposium was supported in part by an educational grant from DuPont Pharmaceuticals.
-
Requests for Reprints: Greg Albers, MD, Neurology (127), Palo Alto Veterans Affairs Medical Center, Palo Alto, CA 94304.
-
Current Author Addresses: Dr. Albers: Department of Neurology and Neurological Sciences, Stanford University Medical Center, Stanford, CA 94305.
Dr. Atwood: Division of Cardiology, Stanford University Medical Center, Stanford, CA 94305.
Dr. Connolly: Faculty of Health Science, McMaster University, Hamilton, Ontario L8L 2X2.
Dr. Hirsh: Hamilton Civic Hospital Research Center, Hamilton, Ontario L8V 1C3.
Dr. Hughes: 275 Cambridge Street, Suite 200, Boston, MA 02114. Dr. Sherman: Division of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, TX 78284.
