Reviews in Clinical Gerontology


Factors contributing to the stability of anticoagulation control and outcome of thromboembolic prophylaxis in the older population

Hilary Wynne a1c1, Tayyaba Khan a2, Elizabeth Sconce a2 and Farhad Kamali a2
a1 Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle upon Tyne, UK
a2 University of Newcastle upon Tyne, Newcastle upon Tyne, UK

Article author query
wynne h   [PubMed][Google Scholar] 
khan t   [PubMed][Google Scholar] 
sconce e   [PubMed][Google Scholar] 
kamali f   [PubMed][Google Scholar] 

Meta-analyses of randomized controlled trials have reported the efficacy of dose-adjusted warfarin therapy (target International Normalised Ratio (INR) 2–3) in reducing stroke risk in atrial fibrillation by 68%, with aspirin reducing relative risk by 22%. Absolute benefit for an individual patient depends on the presence of the risk factors for stroke; these include previous stroke, transient ischaemic attack, hypertension, diabetes, valvular heart disease, heart failure and advanced age. In spite of reported benefit, many people with atrial fibrillation and a high risk of stroke are not receiving anticoagulation: disappointingly, risk stratification is not being sufficiently used to guide treatment.

(Published Online December 21 2006)

c1 Address for correspondence: H A Wynne, Department of Care of the Elderly, Royal Victoria Infirmary, Queen Victoria Road, Newcastle-upon-Tyne, NE1 4LP, UK.