Some of the risk factors for anticoagulation-related bleeding are also indications for the use of anticoagulants in AF patients .
Atrial fibrillation ( AF ) is associated with an increased stroke risk that may be reduced by therapeutic anticoagulation .
However , anticoagulation is associated with an increased risk of bleeding that in some patients may outweigh the benefits in reducing the risk of stroke .
Prospective cohort study to determine if trial efficacy of anticoagulation for stroke prevention in atrial fibrillation translates into clinical effectiveness
Abstract Objective : To determine whether trial efficacy of prophylaxis with warfarin for patients with atrial fibrillation at high risk of stroke translates into effectiveness in clinical practice . Design : Two year prospect i ve cohort study . Setting : District general hospital . Participants : 167 patients with atrial fibrillation and at high stroke risk who were eligible for anticoagulation Interventions : Long term anticoagulation with warfarin at adjusted doses to maintain an international normalised ratio of 2.0 - 3.0 Main outcome measures : Comparison of patient characteristics , comorbidity , anticoagulation control , stroke rate , and haemorrhagic complications with pooled data from five r and omised controlled trials . Results : Patients in the study group were seven years older ( 95 % confidence interval 4 to 10 ) and comprised 33 % more women than patients in the pooled trials . The international normalised ratio was in the target range for 61 % of the time ( range 37%-85 % ) , below for 26 % of the time ( range 8%-32 % ) , and above for 13 % of the time ( range 6%-26 % ) . The time that patients in the study group spent in the target range was significantly less than in the pooled analysis . The incidence of stroke in the study group ( 2.0 % per year , 0.7 % to 4.4 % ) was comparable to that of patients receiving warfarin in pooled studies ( 1.4 % , 0.8 % to 2.3 % ) . Per year the incidence of major ( 1.7 % v 1.6 % ) and minor ( 5.4 % v 9.2 % ) bleeding complications was also similar . Conclusion : Rates of stroke and major haemorrhage after anticoagulation in clinical practice were comparable to those obtained from pooled data from r and omised controlled studies for patients with atrial fibrillation at high risk of
Some of the risk factors for anticoagulation-related bleeding are also indications for the use of anticoagulants in AF patients .
Atrial fibrillation ( AF ) is associated with an increased stroke risk that may be reduced by therapeutic anticoagulation .
However , anticoagulation is associated with an increased risk of bleeding that in some patients may outweigh the benefits in reducing the risk of stroke .