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Preventing stroke in atrial fibrillation

P A Wolf1, D E Singer

  • 1Boston University School of Medicine, Massachusetts, USA.

American Family Physician
|December 24, 1997
PubMed
Summary

Atrial fibrillation significantly increases stroke risk. Warfarin anticoagulation effectively prevents strokes in these patients with a low risk of bleeding.

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Area of Science:

  • Cardiology
  • Neurology
  • Clinical Trials

Background:

  • Atrial fibrillation is a common cardiac arrhythmia.
  • Previously, stroke risk in atrial fibrillation was linked mainly to rheumatic heart disease.
  • The impact of nonvalvular atrial fibrillation on stroke was underestimated.

Purpose of the Study:

  • To assess the stroke risk associated with atrial fibrillation.
  • To evaluate the efficacy of warfarin anticoagulation for stroke prevention in atrial fibrillation patients.

Main Methods:

  • Review of clinical trials on atrial fibrillation and stroke.
  • Analysis of stroke incidence, recurrence, and mortality data.
  • Assessment of bleeding risks associated with warfarin therapy.

Main Results:

  • Atrial fibrillation increases stroke incidence five-fold.
  • Warfarin anticoagulation demonstrated significant efficacy in stroke prevention.
  • The benefits of anticoagulation were achieved with an acceptable risk of serious hemorrhage.

Conclusions:

  • Nonvalvular atrial fibrillation is a major stroke risk factor.
  • Warfarin is an effective stroke prevention strategy for patients with atrial fibrillation.
  • Anticoagulation therapy offers a favorable risk-benefit profile in this population.

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