OTHER
Therapeutics
Oral anticoagulant therapy safely prevented stroke in older patients with atrial fibrillation
| The first 150 words of the full text of this article appear below. |
individual patient data meta-analysis of 12 randomised controlled trials (RCTs). 6 RCTs were placebo-controlled; 8 RCTs compared an oral anticoagulant (OAC) with an antiplatelet (AP).
outcome adjudication committee was blinded in 11 trials.
8932 adults (mean age 72 y, 63% men) with non-valvular atrial fibrillation. Patients with clinical indications for or against any of the active therapies were excluded.
full-dose OACs (mainly warfarin sodium or 4-hydroxycoumarin) with lower target international normalised ratio (INR) of 1.5–2.8 and upper target INR of 2.7–4.2 (n = 3430); APs (mainly acetylsalicylic acid, 75–325 mg) with or without low-dose OACs (median INR <1.5; n = 3531); or placebo (n = 1971).
ischaemic stroke, serious bleeding, and cardiovascular events (ischaemic stroke, myocardial infarction, systemic embolism, or vascular death). Intention-to-treat analysis.
mean 2 years.
Older age was associated with increased risk of all outcomes (table). Independent of age and other covariates, both OACs and APs decreased
Mount Sinai School of Medicine, New York, New York, USA
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