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Date of download: 7/10/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Choice of Antithrombotic Therapy for Stroke Prevention.

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Presentation on theme: "Date of download: 7/10/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Choice of Antithrombotic Therapy for Stroke Prevention."— Presentation transcript:

1 Date of download: 7/10/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Choice of Antithrombotic Therapy for Stroke Prevention in Atrial Fibrillation: Warfarin, Aspirin, or Both? Arch Intern Med. 1998;158(14):1487-1491. doi:10.1001/archinte.158.14.1487 Rates of major bleeding events among patients receiving warfarin sodium compared with aspirin from the pooled analysis of 5 trials performed by the Atrial Fibrillation Investigators (AFI) and the Stroke Prevention in Atrial Fibrillation II (SPAF II) study. In the AFI analysis, major hemorrhage was defined as intracranial bleeding or a bleeding event that required hospitalization or 2 U blood. In the SPAF II trial, major bleeding was defined as a hemorrhagic event that involved the central nervous system; required hospitalization, blood transfusion, and/or surgical intervention; or resulted in permanent functional impairment to any degree. Figure Legend:

2 Date of download: 7/10/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Choice of Antithrombotic Therapy for Stroke Prevention in Atrial Fibrillation: Warfarin, Aspirin, or Both? Arch Intern Med. 1998;158(14):1487-1491. doi:10.1001/archinte.158.14.1487 Cumulative rate of minor and major bleeding events in the second Copenhagen Atrial Fibrillation, Aspirin, and Anticoagulation Study. Major bleeding events were defined as fatal, life-threatening, or requiring surgical treatment or blood transfusion. Study medications are described on page 1487. Figure Legend:

3 Date of download: 7/10/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Choice of Antithrombotic Therapy for Stroke Prevention in Atrial Fibrillation: Warfarin, Aspirin, or Both? Arch Intern Med. 1998;158(14):1487-1491. doi:10.1001/archinte.158.14.1487 Rates of stroke or systemic embolism, major bleeding events, and intracranial hemorrhage in the Stroke Prevention in Atrial Fibrillation III trial (intention-to-treat analysis). The target range of international normalized ratio of prothrombin time for combined aspirin and low-intensity, fixed-dose warfarin was 1.2 to 1.5; for adjusted-dose warfarin, 2.0 to 3.0. Figure Legend:

4 Date of download: 7/10/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Choice of Antithrombotic Therapy for Stroke Prevention in Atrial Fibrillation: Warfarin, Aspirin, or Both? Arch Intern Med. 1998;158(14):1487-1491. doi:10.1001/archinte.158.14.1487 Analysis of the rate of ischemic stroke or systemic embolism in patients randomized to warfarin vs aspirin therapies, while receiving treatment, in 3 prospective studies. Transient ischemic attacks and intracranial hemorrhages are not included. Event rates are based on a calculation of the cumulative rate of ischemic strokes or systemic emboli that occurred in patients before permanent discontinuation of therapy. AFASAK indicates first Copenhagen Atrial Fibrillation, Aspirin, and Anticoagulation Study; SPAF II, Stroke Prevention in Atrial Fibrillation II trial; and AFASAK 2, second AFASAK Study. Figure Legend:

5 Date of download: 7/10/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Choice of Antithrombotic Therapy for Stroke Prevention in Atrial Fibrillation: Warfarin, Aspirin, or Both? Arch Intern Med. 1998;158(14):1487-1491. doi:10.1001/archinte.158.14.1487 Differences in the absolute risk reduction for a high-risk subgroup (70 years old with atrial fibrillation [AF] and recent stroke or transient ischemic attack [TIA]) of patients with atrial fibrillation compared with a low-risk subgroup (70 years old with AF unassociated with other risk factors). Relative risk reduction for warfarin therapy is similar in both groups; however, the absolute risk reduction is considerably larger among the high-risk patients (Δ [a change of] 6% [17 patients treated for 1 year prevents 1 stroke] vs Δ1% [100 patients treated for 1 year prevents 1 stroke]). Figure Legend:


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