Female sex was inconsistently associated with stroke risk , whereas the evidence was inconclusive that either heart failure or coronary artery disease is independently predictive of stroke .
Conclusions : Four clinical features ( prior stroke/TIA , advancing age , hypertension , diabetes ) are consistent independent risk factors for stroke in atrial fibrillation patients .
Background : Absolute stroke rates vary widely among patients with nonvalvular atrial fibrillation .
To balance the benefits and risks of chronic antithrombotic prophylaxis , it is important to estimate the absolute risk of stroke for individual patients .
A comparison of warfarin and aspirin for the prevention of recurrent ischemic stroke.
BACKGROUND Despite the use of antiplatelet agents , usually aspirin , in patients who have had an ischemic stroke , there is still a substantial rate of recurrence . Therefore , we investigated whether warfarin , which is effective and superior to aspirin in the prevention of cardiogenic embolism , would also prove superior in the prevention of recurrent ischemic stroke in patients with a prior noncardioembolic ischemic stroke . METHODS In a multicenter , double-blind , r and omized trial , we compared the effect of warfarin ( at a dose adjusted to produce an international normalized ratio of 1.4 to 2.8 ) and that of aspirin ( 325 mg per day ) on the combined primary end point of recurrent ischemic stroke or death from any cause within two years . RESULTS The two r and omized study groups were similar with respect to base-line risk factors . In the intention-to-treat analysis , no significant differences were found between the treatment groups in any of the outcomes measured . The primary end point of death or recurrent ischemic stroke was reached by 196 of 1103 patients assigned to warfarin ( 17.8 percent ) and 176 of 1103 assigned to aspirin ( 16.0 percent ; P=0.25 ; hazard ratio comparing warfarin with aspirin , 1.13 ; 95 percent confidence interval , 0.92 to 1.38 ) . The rates of major hemorrhage were low ( 2.22 per 100 patient-years in the warfarin group and 1.49 per 100 patient-years in the aspirin group ) . Also , there were no significant treatment-related differences in the frequency of or time to the primary end point or major hemorrhage according to the cause of the initial stroke ( 1237 patients had had previous small-vessel or lacunar infa rcts , 576 had had cryptogenic infa rcts , and 259 had had infa rcts design ated as due to severe stenosis or occlusion of a large artery ) . CONCLUSIONS Over two years , we found no difference between aspirin and warfarin in the prevention of recurrent ischemic stroke or death or in the rate of major hemorrhage . Consequently , we regard both warfarin and aspirin as reasonable therapeutic alternatives
Female sex was inconsistently associated with stroke risk , whereas the evidence was inconclusive that either heart failure or coronary artery disease is independently predictive of stroke .
Conclusions : Four clinical features ( prior stroke/TIA , advancing age , hypertension , diabetes ) are consistent independent risk factors for stroke in atrial fibrillation patients .
Background : Absolute stroke rates vary widely among patients with nonvalvular atrial fibrillation .
To balance the benefits and risks of chronic antithrombotic prophylaxis , it is important to estimate the absolute risk of stroke for individual patients .