Antiplatelet therapy for preventing stroke in patients with non-valvular atrial fibrillation and no previous history of stroke or transient ischemic attacks
The Cochrane Database of Systematic ReviewsPublished 25 October 1999
Oscar Benavente, Robert G. Hart, Peter J. Koudstaal, Andreas Laupacis, Ruth McBride
Citations29
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TL;DR
Considering all randomized data, aspirin modestly reduces stroke and major vascular events in nonvalvular AF, and reductions in these events by aspirin were consistently smaller and marginally statistically significant.
Abstract
Considering all randomized data, aspirin modestly (by about 20%) reduces stroke and major vascular events in nonvalvular AF. For primary prevention among AF patients with an average stroke rate of 4.5%/year, about 10 strokes would be prevented yearly for every 1000 given aspirin.
Keywords
Medicine
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It is concluded that lone atrial fibrillation in patients under the age of 60 at diagnosis is associated with a very low risk of stroke, and routine anticoagulation may not be warranted.
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Patients with AF who have high and low rates of stroke during treatment with aspirin can be identified and validation of the risk stratification scheme is necessary before it can be applied with confidence to clinical management.
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Indobufen, a reversible inhibitor of platelet cyclooxygenase, with warfarin may help the medical community in devising appropriate antithrombotic strategies for NRAF patients for whom oral anticoagulants are contraindicated or do not represent a feasible approach to treatment.
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Exploratory analyses suggest that many AF patients may have a relatively low thromboembolic rate when given aspirin, but the findings must be independently confirmed before being applied to clinical management.
