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Titolo:
Antithrombotic therapy to prevent stroke in patients with atrial fibrillation: A meta-analysis
Autore:
Hart, RG; Benavente, O; McBride, R; Pearce, LA;
Indirizzi:
Univ Texas, Hlth Sci Ctr, Dept Med Neurol, San Antonio, TX 78284 USA Univ Texas San Antonio TX USA 78284 Med Neurol, San Antonio, TX 78284 USA Axio Res Corp, Seattle, WA 98105 USA Axio Res Corp Seattle WA USA 98105Axio Res Corp, Seattle, WA 98105 USA
Titolo Testata:
ANNALS OF INTERNAL MEDICINE
fascicolo: 7, volume: 131, anno: 1999,
pagine: 492 -
SICI:
0003-4819(19991005)131:7<492:ATTPSI>2.0.ZU;2-P
Fonte:
ISI
Lingua:
ENG
Soggetto:
FIXED MINIDOSE WARFARIN; THROMBOEMBOLIC COMPLICATIONS; RANDOMIZED TRIAL; CLINICAL-TRIALS; ANTICOAGULATION; ASPIRIN; INDOBUFEN; INTENSITY; EVENTS;
Keywords:
meta-analysis; cerebrovascular disorders; atrial fibrillation; anticoagulants platelet aggregation inhibitors;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
30
Recensione:
Indirizzi per estratti:
Indirizzo: Hart, RG Univ Texas, Hlth Sci Ctr, Dept Med Neurol, 7703 Floyd Curl Dr, San Antonio, TX 78284 USA Univ Texas 7703 Floyd Curl Dr San Antonio TX USA 78284 78284 USA
Citazione:
R.G. Hart et al., "Antithrombotic therapy to prevent stroke in patients with atrial fibrillation: A meta-analysis", ANN INT MED, 131(7), 1999, pp. 492

Abstract

Purpose: To characterize the efficacy and safety of anticoagulants and antiplatelet agents for prevention of stroke in patients with atrial fibrillation. Data Sources: Randomized trials identified by using the search strategy developed by the Cochrane Collaboration Stroke Review Group. Study Selection: All published randomized trials testing antithrombotic agents to prevent stroke in patients with atrial fibrillation. Data Extraction: Data on interventions, number of participants, duration of exposure and occurrence of all stroke (ischemic and hemorrhagic), major extracranial bleeding, and death were extracted independently by two investigators. Data Synthesis: Sixteen trials included a total of 9874 participants (meanfollow-up, 1.7 years). Adjusted-dose warfarin (six trials, 2900 participants) reduced stroke by 62% (95% CI, 48% to 72%); absolute risk reductions were 2.7% per year for primary prevention and 8.4% per year for secondary prevention. Major extracranial bleeding was increased by warfarin therapy (absolute risk increase, 0.3% per year). Aspirin (six trials, 3119 participants) reduced stroke by 22% (CI, 2% to 38%); absolute risk reductions were 1.5%per year for primary prevention and 2.5% per year for secondary prevention. Adjusted-dose warfarin (five trials, 2837 participants) was more efficacious than aspirin (relative risk reduction, 36% [CI, 14% to 52%]). Other randomized comparisons yielded inconclusive results. Conclusions: Adjusted-dose warfarin and aspirin reduce stroke in patients with atrial fibrillation, and warfarin is substantially more efficacious than aspirin. The benefit of antithrombotic therapy was not offset by the occurrence of major hemorrhage among participants in randomized trials. Judicious use of antithrombotic therapy, tailored according to the inherent risk for stroke, importantly reduces stroke in patients with atrial fibrillation.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/12/20 alle ore 10:56:11