Fixed Minidose Warfarin and Aspirin Alone and in Combination vs Adjusted-Dose Warfarin for Stroke Prevention in Atrial Fibrillation

华法林 阿司匹林 医学 心房颤动 冲程(发动机) 华法林钠 内科学 心肌梗塞 随机对照试验 麻醉 心脏病学 外科 机械工程 工程类
作者
Annette Lemche Gulløv,Birgitte Gade Koefoed,Palle Petersen,Trine Sander Pedersen,E Andersen,John Godtfredsen,Gudrun Boysen
出处
期刊:Archives of internal medicine [American Medical Association]
卷期号:158 (14): 1513-1513 被引量:290
标识
DOI:10.1001/archinte.158.14.1513
摘要

Despite the efficacy of warfarin sodium therapy for stroke prevention in atrial fibrillation, many physicians hesitate to prescribe it to elderly patients because of the risk for bleeding complications and because of inconvenience for the patients.The Second Copenhagen Atrial Fibrillation, Aspirin, and Anticoagulation Study was a randomized, controlled trial examining the following therapies: warfarin sodium, 1.25 mg/d; warfarin sodium, 1.25 mg/d, plus aspirin, 300 mg/d; and aspirin, 300 mg/d. These were compared with adjusted-dose warfarin therapy (international normalized ratio of prothrombin time [INR], 2.0-3.0). Stroke or a systemic thromboembolic event was the primary outcome event. Transient ischemic attack, acute myocardial infarction, and death were secondary events. Data were handled as survival data, and risk factors were identified using the Cox proportional hazards model. The trial was scheduled for 6 years from May 1, 1993, but due to scientific evidence of inefficiency of low-intensity warfarin plus aspirin therapy from another study, our trial was prematurely terminated on October 2, 1996.We included 677 patients (median age, 74 years). The cumulative primary event rate after 1 year was 5.8% in patients receiving minidose warfarin; 7.2%, warfarin plus aspirin; 3.6%, aspirin; and 2.8%, adjusted-dose warfarin (P = .67). After 3 years, no difference among the groups was seen. Major bleeding events were rare.Although the difference was insignificant, adjusted-dose warfarin seemed superior to minidose warfarin and to warfarin plus aspirin after 1 year of treatment. The results do not justify a change in the current recommendation of adjusted-dose warfarin (INR, 2.0-3.0) for stroke prevention in atrial fibrillation.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
xiaoming发布了新的文献求助200
刚刚
刚刚
QT完成签到,获得积分20
1秒前
朱华彪完成签到,获得积分10
1秒前
活在当下发布了新的文献求助10
1秒前
1秒前
haha发布了新的文献求助10
2秒前
aurora完成签到 ,获得积分10
3秒前
茉莉完成签到,获得积分10
3秒前
123完成签到,获得积分10
5秒前
5秒前
wwewew完成签到,获得积分10
6秒前
saying发布了新的文献求助10
6秒前
123123完成签到,获得积分10
6秒前
隐形曼青应助阿卡宁采纳,获得10
7秒前
负责紊完成签到,获得积分10
7秒前
善良的火发布了新的文献求助10
9秒前
haha完成签到,获得积分10
9秒前
11秒前
sugar完成签到,获得积分10
12秒前
活在当下完成签到,获得积分10
12秒前
14秒前
ssy发布了新的文献求助10
14秒前
小嘉贞完成签到,获得积分10
16秒前
鸡蛋黄完成签到,获得积分10
17秒前
温纲完成签到,获得积分10
18秒前
lalafish完成签到,获得积分10
18秒前
研友_nV2Kyn完成签到,获得积分10
19秒前
王冉冉发布了新的文献求助10
19秒前
铁甲小宝完成签到,获得积分10
20秒前
ssy完成签到,获得积分10
22秒前
低头应助gtt采纳,获得10
24秒前
芝士momoRIN完成签到,获得积分10
24秒前
wxx完成签到,获得积分10
25秒前
yar应助时尚的闭月采纳,获得10
26秒前
酷波er应助时尚的闭月采纳,获得10
26秒前
量子星尘发布了新的文献求助10
28秒前
zy完成签到 ,获得积分10
29秒前
花Cheung完成签到,获得积分10
29秒前
29秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
Research on Disturbance Rejection Control Algorithm for Aerial Operation Robots 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038524
求助须知:如何正确求助?哪些是违规求助? 3576221
关于积分的说明 11374737
捐赠科研通 3305912
什么是DOI,文献DOI怎么找? 1819354
邀请新用户注册赠送积分活动 892688
科研通“疑难数据库(出版商)”最低求助积分说明 815048