Evidence-based study on antithrombotic therapy in patients at risk of a stroke with paroxysmal atrial fibrillation

Chen,Xinjun; Wan,Ronghua; Jiang,Wenlong; Zhang,Hua; Zhen,Ruolong; Ying,Quanzhong; Li,Weizhang; Qian,Huidong; Wei,Feng; Xu,Zhuowen; Tang,Jianjin; Lei,Handong; Zhou,Yi

doi:10.3892/etm.2013.1141

August 2013 Volume 6 Issue 2

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August 2013 Volume 6 Issue 2

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Article

Evidence-based study on antithrombotic therapy in patients at risk of a stroke with paroxysmal atrial fibrillation

Authors:
- Xinjun Chen
- Ronghua Wan
- Wenlong Jiang
- Hua Zhang
- Ruolong Zhen
- Quanzhong Ying
- Weizhang Li
- Huidong Qian
- Feng Wei
- Zhuowen Xu
- Jianjin Tang
- Handong Lei
- Yi Zhou
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Affiliations: Department of Cardiology, Affiliated Jiangyin Hospital, College of Medicine, Southeast University, Jiangyin, Jiangsu 214400, P.R. China, Department of Cardiovascular Surgery, Heart Center, General Hospital of Ningxia Medical University, Yinchuan, Ningxia 750004, P.R. China, Department of Cardiology, The Second People's Hospital of Panyu, Panyu, Guangdong 511470, P.R. China, Department of Cardiology, Wuhan Central Hospital, Wuhan, Hubei 430014, P.R. China
Pages: 413-418
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Published online on: June 5, 2013

https://doi.org/10.3892/etm.2013.1141
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Abstract

The aim of the present study was to determine the optimal intensity of anticoagulation therapy in elderly patients with paroxysmal atrial fibrillation (PAF), using aspirin and varied concentrations of warfarin. Elderly patients with PAF (n=1,162) who met the inclusion criteria of the study and were at middle or high‑risk of a stroke were investigated. Patients were divided into six groups (four high-risk groups and two middle-risk groups). Patients were treated with aspirin or varied concentrations of warfarin. The primary endpoint events, secondary endpoint events, major bleeding events and minor bleeding events were observed and compared. In high‑risk elderly patients, warfarin significantly reduced primary and secondary endpoint events, total primary events and total events compared with aspirin. In middle-risk elderly patients, for all the events warfarin demonstrated no significant difference compared with aspirin. In high-risk patients with PAF, when the concentration of warfarin was adjusted to target international normalized ratio (INR) range 1.7‑2.5, the primary and secondary endpoint events, total primary events and total events were significantly lower (P<0.05), compared with aspirin and warfarin at INR 1.2‑1.6. When the intensity of warfarin was adjusted to the target INR 2.6‑3.0, the primary and secondary endpoint events were significantly lower (P<0.05) compared with aspirin and warfarin INR at 1.2‑1.6. This study determined that in high‑risk elderly patients with PAF, warfarin is recommended for anticoagulation with an optimal INR range of 1.7‑2.5. In patients at a middle-risk of a stroke, aspirin is the recommended treatment as an antithrombotic as results have indicated that there is limited benefit in the use of warfarin.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Evidence-based study on antithrombotic therapy in patients at risk of a stroke with paroxysmal atrial fibrillation

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