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

Published online by Cambridge University Press:  21 December 2006

Hilary Wynne
Affiliation:
Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle upon Tyne, UK
Tayyaba Khan
Affiliation:
University of Newcastle upon Tyne, Newcastle upon Tyne, UK
Elizabeth Sconce
Affiliation:
University of Newcastle upon Tyne, Newcastle upon Tyne, UK
Farhad Kamali
Affiliation:
University of Newcastle upon Tyne, Newcastle upon Tyne, UK

Abstract

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.

Type
Occasional
Copyright
2006 Cambridge University Press

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