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Titolo:
BLEEDING DURING ANTITHROMBOTIC THERAPY IN PATIENTS WITH ATRIAL-FIBRILLATION
Autore:
CHESEBRO JH; WIEBERS DO; HOLLAND AE; BARDSLEY WT; LITIN SC; MEISSNER I; ZERBE DM; FLAKER GC; WEBEL R; NOLTE B; STEVENSON P; BYER J; WRIGHT W; ANDERSON DC; ASINGER RW; NEWBURG SM; BUNDLIE SR; FARMER CC; KOLLER RL; HAUGLAND JM; NANCE MA; TARREL RM; DUNBAR DN; JORGENSEN CR; SHARKEY SW; LEONARD AD; KANTER MC; SOLOMON DH; ZABALGOITIA M; MCANULTY JH; MARCHANT C; COULL BM; KELLEY RE; CHAHINE R; PALERMO M; TEIXEIRO P; FELDMAN G; HAYWARD A; MACMILLAN K; GANDARA E; ANDERSON W; BLANK N; STRAUSS R; FEINBERG WM; VOLD BK; KERN KB; APPLETON C; BRUCK D; DORR S; DITTRICH HC; ROTHROCK JF; HAGENHOFF C; LOGAN WR; HAMILTON WP; GREEN BJ; BACON RS; HELGASON CM; KONDOS GT; HOFF J; HALPERIN JL; ROTHLAUF EB; WEINBERGER JM; GOLDMAN ME; MILLER VT; HOCKERSMITH CJ; COHEN BA; JANOSIK DL; CADELL DJ; KELLERMAN L; GOMEZ CR; LABOVITZ AJ; ROTHBART RM; BAILEY GH; BURKHARDT C; HORWITZ L; BLACKSHEAR JL; WEAVER L; BAKER V; LEE G; LANE G; RUBINO F; SAFFORD R; KRONMAL RA; MCBRIDE R; PEARCE L; FLETCHER KA; NASCO E; HART RG; SHERMAN DG; TALBERT RL; HEBERLING PA; COLTON T; LEVY DE; MARSH JD; WELCH KMA; MARLER JR; WALKER MD;
Indirizzi:
HENNEPIN CTY MED CTR,DEPT NEUROL,701 PK AVE S MINNEAPOLIS MN 55415 HENNEPIN CTY MED CTR,DEPT NEUROL MINNEAPOLIS MN 55415 MAYO CLIN & MAYO FDN ROCHESTER MN 55905 UNIV MISSOURI COLUMBIA MO 00000 ABBOTT NW HOSP MINNEAPOLIS MN 00000 PARK NICOLLET MED CTR MINNEAPOLIS MN 00000 UNIV TEXAS,HLTH SCI CTR SAN ANTONIO TX 00000 AUDIE L MURPHY MEM VET ADM MED CTR SAN ANTONIO TX 78284 OREGON HLTH SCI UNIV PORTLAND OR 97201 UNIV MIAMI,SCH MED MIAMI FL 00000 KAISER PERMANENTE PORTLAND OR 00000 UNIV ARIZONA,COLL MED TUCSON AZ 00000 UNIV CALIF SAN DIEGO,MED CTR LA JOLLA CA 92093 ST JOHNS MERCY MED CTR ST LOUIS MO 63141 UNIV ILLINOIS,COLL MED CHICAGO IL 00000 UNIV ILLINOIS,COLL MED PEORIA IL 61656 MT SINAI MED CTR NEW YORK NY 10029 NORTHWESTERN UNIV,SCH MED CHICAGO IL 00000 ST LOUIS UNIV,MED CTR ST LOUIS MO 00000 UNIV COLORADO,SCH MED DENVER CO 00000 MAYO CLIN JACKSONVILLE FL 32224 UNIV WASHINGTON SEATTLE WA 98195 STAT & EPIDEMIOL RES CORP SEATTLE WA 00000 BOSTON UNIV BOSTON MA 02215 KNOLL PHARMACEUT WHIPPANY NJ 00000 HARVARD UNIV BOSTON MA 02115 HENRY FORD HOSP DETROIT MI 48202 NINCDS BETHESDA MD 20892
Titolo Testata:
Archives of internal medicine
fascicolo: 4, volume: 156, anno: 1996,
pagine: 409 - 416
SICI:
0003-9926(1996)156:4<409:BDATIP>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
ORAL ANTICOAGULANT-THERAPY; PROSTHETIC HEART-VALVES; PROTHROMBIN-TIME RATIO; INTRACEREBRAL HEMORRHAGE; THROMBOEMBOLIC COMPLICATIONS; DIFFERENT INTENSITIES; RISK-FACTORS; WARFARIN; OUTPATIENTS; TRIAL;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
67
Recensione:
Indirizzi per estratti:
Citazione:
J.H. Chesebro et al., "BLEEDING DURING ANTITHROMBOTIC THERAPY IN PATIENTS WITH ATRIAL-FIBRILLATION", Archives of internal medicine, 156(4), 1996, pp. 409-416

Abstract

Background: The Stroke Prevention in Atrial Fibrillation II study compared warfarin vs aspirin for stroke prevention in atrial fibrillation. Bleeding complications importantly detracted from warfarin's net effectiveness, particularly among older patients. Objectives: To analyze bleeding complications according to assigned therapy. To identify riskfactors for bleeding during anticoagulation. Methods: Eleven hundred patients (mean age, 70 years) were randomized to 325 mg of aspirin daily (enteric coated) vs warfarin (target prothrombin time ratio, 1.3 to1.8; approximate international normalized ratio, 2.0 to 4.5). Major hemorrhages were defined prospectively. Results: The rate of major bleeding while receiving warfarin was 2.3% per year (95% confidence interval [CI], 1.7 to 3.2) vs 1.1% per year (95% CI, 0.7 to 1.8) while receiving aspirin (relative risk, 2.1; 95% CI, 1.1 to 3.1; P=.02). Intracranial hemorrhage occurred at 0.9% per year (95% CI, 0.5 to 1.5) with warfarin and 0.3% per year (95% CI, 0.1 to 0.8) with aspirin (relative risk, 2.4; P=.08). Age (P=.006), increasing number of prescribed medications (P=.007), and intensity of anticoagulation (P=.02) were independent risks for bleeding at any site during anticoagulation. The rate ofmajor hemorrhage was 1.7% per year in patients aged 75 years or younger who received anticoagulation vs 4.2% per year in older patients (relative risk, 2.6, P=.009); rates by age for intracranial bleeding were0.6% per year and 1.8% per year, respectively (P=.05). Conclusion: Advancing age and more intense anticoagulation increase the risk of major hemorrhage in patients given warfarin for stroke prevention.

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Documento generato il 30/11/20 alle ore 11:24:48