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Review: warfarin prevents stroke in non-rheumatic atrial fibrillation but has a higher risk for haemorrhage than other agents

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 QUESTION: In patients with non-rheumatic atrial fibrillation (AF), how effective are anticoagulants and antiplatelet drugs in preventing thromboembolic complications?

Data sources

Studies were identified by searching 3 databases and relevant journals.

Study selection

Studies were selected if they were randomised controlled trials (RCTs) evaluating warfarin, aspirin, combined low dose warfarin and aspirin, low molecular weight heparin, or indobufen for prevention of thromboembolism in AF or atrial flutter and if the outcomes were stroke, major bleeding, or death.

Data extraction

Data were extracted on study quality; patient characteristics and inclusion and exclusion criteria; therapeutic protocol, including intensity of coagulation and percentage of time inside and outside of the target range; and results.

Main results

14 RCTs were included. 6 RCTs compared warfarin with placebo: warfarin reduced the risk for stroke but increased the risk for …

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