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Titolo:
PATIENTS WITH NONVALVULAR ATRIAL-FIBRILLATION AT LOW-RISK OF STROKE DURING TREATMENT WITH ASPIRIN - STROKE PREVENTION IN ATRIAL-FIBRILLATION III STUDY
Autore:
ANDERSON DC; HALPERIN JL; HART RG; MCANULTY JH; MCBRIDE R; PEARCE LA; SHERMAN DG;
Indirizzi:
SPAF STAT COORDINATING CTR,1107 NE 45TH ST,SUITE 520 SEATTLE WA 98105 SPAF STAT COORDINATING CTR SEATTLE WA 98105
Titolo Testata:
JAMA, the journal of the American Medical Association
fascicolo: 16, volume: 279, anno: 1998,
pagine: 1273 - 1277
SICI:
0098-7484(1998)279:16<1273:PWNAAL>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
ISCHEMIC STROKE; SEVERITY; EVENTS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
25
Recensione:
Indirizzi per estratti:
Citazione:
D.C. Anderson et al., "PATIENTS WITH NONVALVULAR ATRIAL-FIBRILLATION AT LOW-RISK OF STROKE DURING TREATMENT WITH ASPIRIN - STROKE PREVENTION IN ATRIAL-FIBRILLATION III STUDY", JAMA, the journal of the American Medical Association, 279(16), 1998, pp. 1273-1277

Abstract

Context.-Nonvalvular atrial fibrillation (AF) carries an increased risk for stroke, but absolute rates of stroke vary widely within the broad spectrum of AF patients. Objective.-To prospectively validate a risk stratification scheme identifying patients with AF with low rates ofstroke when given aspirin. Design.-Prospective cohort study with meanduration of follow-up of 2.0 years, conducted between 1993 and 1997. Setting.-Outpatient clinics affiliated with academic medical centers. Patients.-Patients with AF categorized as ''low risk'' based on the absence of 4 prespecified thromboembolic risk factors: recent congestiveheart failure or left ventricular fractional shortening of 25% or less, previous thromboembolism, systolic blood pressure greater than 160 mm Hg, or female sex at age older than 75 years. Intervention.-All participants given aspirin, 325 mg/d. Main Outcome Measures.-Ischemic stroke (considered disabling when Rankin score was II or worse 1-3 monthslater) and systemic embolism (primary events). Results.-Among 892 participants, the mean (SD) age was 67 (10) years, 78% were men, and histories of hypertension, diabetes, and ischemic heart disease were present in 46%, 13%, and 16%, respectively. The rate of primary events was 2.2% per year (95% confidence interval [CI], 1.6%-3.0%), of ischemic stroke was 2.0% per year (95% CI, 1.5%-2.8%), and of disabling ischemicstrokes was 0.8% per year (95% CI, 0.5%-1.3%). Those with a history of hypertension had a higher rate of primary events (3.6% per year) than those with no history of hypertension (1.1% per year) (P<.001). The rate of disabling ischemic stroke was low in those with and without a history of hypertension (1.4% per year and 0.5% per year, respectively). The rate of major bleeding during aspirin therapy was 0.5% per year. Conclusion.-Patients with AF who have relatively low rates of ischemic stroke, particularly disabling stroke, during treatment with aspirin can be reliably identified.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/12/20 alle ore 10:21:45