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