Warfarin for the prevention of systemic embolism in patients with non-valvular atrial fibrillation: a meta-analysis.
|
| Abstract | BACKGROUND:
Warfarin for stroke prevention in patients with atrial fibrillation (AF) is well documented. However, it has not been examined in the prevention of systemic embolism. OBJECTIVES: To evaluate the efficacy of warfarin in preventing systemic embolism (embolism to limbs or viscera) in patients with AF. METHODS AND RESULTS: A combined Medline, Embase, Cochrane Library and SveMed+ search were made. Fifteen studies were included. Warfarin was better than antiplatelet agents for preventing systemic embolism with a 50% reduction of risk (odds ratio (OR) = 0.50, 95% CI 0.33 to 0.75) without increasing the risk of major bleeding (OR = 1.07; 95% CI 0.85 to 1.34). Warfarin compared with placebo resulted in a risk reduction of 71% (OR = 0.29; 95% CI 0.08 to 1.07) with higher risk of major bleeding with warfarin (OR = 3.01; 95% CI 1.31 to 6.92). Results of a comparison of warfarin with low-dose warfarin (OR = 1.52; 95% CI 0.40 to 5.81) or low-dose warfarin with aspirin (OR = 1.00; 95% CI 0.17 to 5.81) were inconclusive. CONCLUSIONS:
Warfarin not only reduces the risk of stroke but is also better than placebo and antiplatelet agents in prevention of systemic embolism in patients with non-valvular AF. Warfarin increases the risk of major bleeding compared with placebo but not compared with antiplatelet agents.
|
|---|---|
| Authors | L V Andersen, P Vestergaard, P Deichgraeber, J S Lindholt, L S Mortensen, L Frost |
| Journal | Heart (British Cardiac Society) (Heart) Vol. 94 Issue 12 Pg. 1607-13 (Dec 2008) ISSN: 1468-201X [Electronic] England |
| PMID | 18208828 (Publication Type: Comparative Study, Journal Article, Meta-Analysis, Review) |
| Chemical References |
|
| Topics |
|
Join CureHunter, for free Research Interface BASIC access!
Realize the full power of the drug-disease research graph!