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Warfarin Reduces Stroke Risk in Atrial Fibrillation

Anticoagulants may be better choice than antiplatelet agents in preventing stroke despite increased risk of bleeding

FRIDAY, Aug. 10 (HealthDay News) -- In elderly patients with atrial fibrillation, anticoagulant agents such as warfarin may reduce the risk of stroke with an acceptable risk of bleeding, according to study findings published in the Aug. 11 issue of The Lancet.

Jonathan Mant, M.D., of the University of Birmingham in the United Kingdom, and colleagues conducted a study of 973 patients aged 75 or older with atrial fibrillation. The patients were followed for a mean of 2.7 years after being randomized to receive either warfarin or 75 mg a day of aspirin.

During the course of the study, there were 24 primary events including 21 strokes, two other intracranial hemorrhages and one systemic embolus in the warfarin group. In the aspirin group there were 48 primary events comprising 44 strokes, one other intracranial hemorrhage, and three systemic emboli.

The study lends weight to the argument in favor of prescribing anticoagulant medications to patients aged 75 and above with atrial fibrillation, with the exception of patients with contraindications and those for whom the inconvenience outweighs the benefit.

"The target INR [international normalized ratio for warfarin] should be 2 to 3, a range in which there is clear evidence of benefit and no evidence from this study of harm compared with aspirin," the authors conclude. "Age itself should not be regarded as a contraindication to anticoagulation therapy."

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