• A G Turpie and S J Connolly.
• Faculty of Health Sciences, McMaster University, Hamilton, Ont.
• Can Fam Physician. 1996 Jul 1; 42: 1341-5.

ObjectiveTo review the evidence for antithrombotic therapy in patients with nonrheumatic atrial fibrillation.Quality Of EvidenceFive primary prevention trials and one secondary prevention trial compare antithrombotic therapy with placebo or no treatment. Two trials also determine the efficacy and safety of acetylsalicylic acid.Main FindingsWarfarin reduces the risk of stroke by 68%. The effect is consistent in all identifiable groups of patients with nonrheumatic atrial fibrillation, except patients at serious risk of hemorrhage. The absolute benefit of anticoagulants varies among patients because of markedly different inherent risk of stroke among patient subgroups.ConclusionsAnticoagulant therapy should be considered for all patients with atrial fibrillation. Oral anticoagulant therapy is more effective than ASA in reducing the risk of stroke among patients with nonrheumatic atrial fibrillation.

18 keywords...

hide…