Are the Results of Randomized Controlled Trials on Anticoagulation in Patients With Atrial Fibrillation Generalizable to Clinical Practice?
Archives of Internal MedicinePublished 11 June 2001
Andrew Evans, Lalit Kalra
Citations120
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TL;DR
Patients who undergo anticoagulation for atrial fibrillation in actual clinical practice differ from those in randomized trials, but have similar rates of stroke and major bleeding.
Abstract
Patients who undergo anticoagulation for atrial fibrillation in actual clinical practice differ from those in randomized trials, but have similar rates of stroke and major bleeding. The risk of minor bleeding is higher and may require more intensive monitoring in practice.
Keywords
MedicineEconomics, Econometrics and Finance
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Long-term low-dose warfarin therapy is highly effective in preventing stroke in patients with non-rheumatic atrial fibrillation, and can be quite safe with careful monitoring.
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Rates of stroke and major haemorrhage after anticoagulation in clinical practice were comparable to those obtained from pooled data from randomised controlled studies for patients with atrial fibrillation at high risk of stroke.
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This review aims to generate a better understanding of the present and projected future global burden of stroke, with particular emphasis on the non-established market economy countries (NEMEC).
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The patients in this study had a rate of bleeds higher than in reported clinical trials, and their older age and greater co-morbidity were the likely causes of this difference.
