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European Heart Journal Advance Access originally published online on April 12, 2007
European Heart Journal 2007 28(8):926-928; doi:10.1093/eurheartj/ehm077
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Stroke prevention in atrial fibrillation: antiplatelet therapy revisited

Gregory Y.H. Lip* and Timothy Watson

Haemostasis, Thrombosis, and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham B18 7QH, UK

* Corresponding author. Tel: +44 121 507 5080; fax: +44 121 554 4803. E-mail address: g.y.h.lip@bham.ac.uk

This editorial refers to ‘Antithrombotic therapy in elderly patients with atrial fibrillation: effects and bleeding complications: a stratified analysis of the NASPEAF randomized trial’{dagger} by F. Pérez-Gómez et al., on page 996

The first 150 words of the full text of this article appear below.

Stroke and thrombo-embolism can be catastrophic complications of atrial fibrillation (AF), and this link is so compelling that up to 15% of all ischaemic stroke can be directly attributable to AF. Nevertheless, therapeutic decisions for stroke prevention have long been guided by many good clinical trials of thromboprophylaxis in AF, which show that adjusted-dose warfarin significantly reduces the risk of ischaemic stroke or systemic embolism compared with placebo [relative risk (RR): 0.33; 95% confidence interval (CI): 0.24–0.45].1 Warfarin is also superior to aspirin (RR: 0.59; 95% CI: 0.40–0.86) or fixed low-dose (low intensity) warfarin therapy for stroke prevention.1 The evidence in favour of warfarin as thromboprophylaxis for AF is therefore irrefutable, especially for ‘high-risk’ patients with AF.

In contrast, the use of aspirin only reduces the risk of stroke in AF by 22% (95% CI: 2–38) compared with control.2 More worryingly, there appears to be a general misconception over the . . . [Full Text of this Article]


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Related articles in EHJ:

Antithrombotic therapy in elderly patients with atrial fibrillation: effects and bleeding complications: a stratified analysis of the NASPEAF randomized trial
Francisco Pérez-Gómez, Jose A. Iriarte, Javier Zumalde, Jesus Berjón, Antonio Salvador, Eduardo Alegría, María P. Maluenda, Susana Asenjo, Rosario Perez-Saldaña, Ricardo Gómez de la Torre, Ramón Bover, and Cristina Fernández
EHJ 2007 28: 996-1003. [Abstract] [FREE Full Text]