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Anticoagulants

Well-managed warfarin still useful for stroke prevention

A study of 40,000 patients with atrial fibrillation suggests that warfarin is a valid treatment for stroke prevention.

Studies of patients with atrial fibrillation (AF) have shown that non-vitamin K oral anticoagulants carry a lower risk of intracranial bleeding than warfarin. But the mean time in therapeutic range (TTR) in these studies was below 70%, suggesting suboptimal warfarin management. 

Researchers from Sweden conducted a retrospective cohort study using data on 40,449 AF patients treated with warfarin over a six-year period to assess the relationship between warfarin management and complications. 

They found that patients with an individual TTR above 70% had a significantly lower incidence of treatment complications. For example, in these patients, the rate of major bleeding was 1.61% compared with 3.81% among those with a lower individual TTR. 

Reporting in JAMA Cardiology  (online, 20 April 2016)[1], the team say the findings suggest that well-managed warfarin treatment remains a valid alternative in patients with AF who require stroke prevention therapy.

Citation: Clinical Pharmacist DOI: 10.1211/CP.2016.20201087

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Supplementary images

  • CT scan of a brain showing intracranial bleeding

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