Incidence of stroke in older persons with atrial fibrillation receiving warfarin versus aspirin

Wilbert S. Aronow, C. Ahn, I. Kronzon, H. Gutstein

Research output: Contribution to journalArticle

Abstract

Purpose: We investigated in a prospective study the incidence of new thromboembolic stroke in older persons with chronic atrial fibrillation receiving warfarin (W) versus aspirin (A). Methods: In a prospective study of 312 patients (pts) (208 women and 104 men), mean age 84±7 years, with chronic atrial fibrillation, 125 pts were treated with long-term W to maintain an INR between 2.0 to 3.0 and 187 pts were treated with A 325 mg daily. The incidence of new stroke was determined in pts receiving W versus A. Follow-up was 36±17 months (range 1 to 99 months). Results: Bleeding episodes caused cessation of W in 4 of 125 pts (3%) and cessation of A in 4 of 187 pts (2%) (p not significant). In pts with prior stroke, new stroke developed in 27 of 67 pts (40%) on W and in 56 of 69 pts (81%) on A (p<0.0001, 50% reduction by W). In pts with no prior stroke, new stroke developed in 13 of 58 pts (22%) on W and in 66 or 118 pts (56%) on A (p <0.0001, 60% reduction by W). Cox regression analysis showed that pts taking W had a 76% less chance of developing a new stroke than those taking A after controlling the confounding effects of other risk factors. Conclusions: W was more effective than A in reducing the incidence of new thromboembolic stroke in older persons with atrial fibrillation. Clinical Implications: Older persons with atrial fibrillation at a high risk for developing stroke and without contraindications to W should be treated with W to maintain an INR between 2.0 to 3.0.

Original languageEnglish (US)
JournalChest
Volume114
Issue number4 SUPPL.
StatePublished - Oct 1998

Fingerprint

Warfarin
Atrial Fibrillation
Aspirin
Stroke
Incidence
International Normalized Ratio
Prospective Studies
Regression Analysis
Hemorrhage

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Incidence of stroke in older persons with atrial fibrillation receiving warfarin versus aspirin. / Aronow, Wilbert S.; Ahn, C.; Kronzon, I.; Gutstein, H.

In: Chest, Vol. 114, No. 4 SUPPL., 10.1998.

Research output: Contribution to journalArticle

Aronow, WS, Ahn, C, Kronzon, I & Gutstein, H 1998, 'Incidence of stroke in older persons with atrial fibrillation receiving warfarin versus aspirin', Chest, vol. 114, no. 4 SUPPL..
Aronow, Wilbert S. ; Ahn, C. ; Kronzon, I. ; Gutstein, H. / Incidence of stroke in older persons with atrial fibrillation receiving warfarin versus aspirin. In: Chest. 1998 ; Vol. 114, No. 4 SUPPL.
@article{83475efbe74643f4bc43a6065ecca101,
title = "Incidence of stroke in older persons with atrial fibrillation receiving warfarin versus aspirin",
abstract = "Purpose: We investigated in a prospective study the incidence of new thromboembolic stroke in older persons with chronic atrial fibrillation receiving warfarin (W) versus aspirin (A). Methods: In a prospective study of 312 patients (pts) (208 women and 104 men), mean age 84±7 years, with chronic atrial fibrillation, 125 pts were treated with long-term W to maintain an INR between 2.0 to 3.0 and 187 pts were treated with A 325 mg daily. The incidence of new stroke was determined in pts receiving W versus A. Follow-up was 36±17 months (range 1 to 99 months). Results: Bleeding episodes caused cessation of W in 4 of 125 pts (3{\%}) and cessation of A in 4 of 187 pts (2{\%}) (p not significant). In pts with prior stroke, new stroke developed in 27 of 67 pts (40{\%}) on W and in 56 of 69 pts (81{\%}) on A (p<0.0001, 50{\%} reduction by W). In pts with no prior stroke, new stroke developed in 13 of 58 pts (22{\%}) on W and in 66 or 118 pts (56{\%}) on A (p <0.0001, 60{\%} reduction by W). Cox regression analysis showed that pts taking W had a 76{\%} less chance of developing a new stroke than those taking A after controlling the confounding effects of other risk factors. Conclusions: W was more effective than A in reducing the incidence of new thromboembolic stroke in older persons with atrial fibrillation. Clinical Implications: Older persons with atrial fibrillation at a high risk for developing stroke and without contraindications to W should be treated with W to maintain an INR between 2.0 to 3.0.",
author = "Aronow, {Wilbert S.} and C. Ahn and I. Kronzon and H. Gutstein",
year = "1998",
month = "10",
language = "English (US)",
volume = "114",
journal = "Chest",
issn = "0012-3692",
publisher = "American College of Chest Physicians",
number = "4 SUPPL.",

}

TY - JOUR

T1 - Incidence of stroke in older persons with atrial fibrillation receiving warfarin versus aspirin

AU - Aronow, Wilbert S.

AU - Ahn, C.

AU - Kronzon, I.

AU - Gutstein, H.

PY - 1998/10

Y1 - 1998/10

N2 - Purpose: We investigated in a prospective study the incidence of new thromboembolic stroke in older persons with chronic atrial fibrillation receiving warfarin (W) versus aspirin (A). Methods: In a prospective study of 312 patients (pts) (208 women and 104 men), mean age 84±7 years, with chronic atrial fibrillation, 125 pts were treated with long-term W to maintain an INR between 2.0 to 3.0 and 187 pts were treated with A 325 mg daily. The incidence of new stroke was determined in pts receiving W versus A. Follow-up was 36±17 months (range 1 to 99 months). Results: Bleeding episodes caused cessation of W in 4 of 125 pts (3%) and cessation of A in 4 of 187 pts (2%) (p not significant). In pts with prior stroke, new stroke developed in 27 of 67 pts (40%) on W and in 56 of 69 pts (81%) on A (p<0.0001, 50% reduction by W). In pts with no prior stroke, new stroke developed in 13 of 58 pts (22%) on W and in 66 or 118 pts (56%) on A (p <0.0001, 60% reduction by W). Cox regression analysis showed that pts taking W had a 76% less chance of developing a new stroke than those taking A after controlling the confounding effects of other risk factors. Conclusions: W was more effective than A in reducing the incidence of new thromboembolic stroke in older persons with atrial fibrillation. Clinical Implications: Older persons with atrial fibrillation at a high risk for developing stroke and without contraindications to W should be treated with W to maintain an INR between 2.0 to 3.0.

AB - Purpose: We investigated in a prospective study the incidence of new thromboembolic stroke in older persons with chronic atrial fibrillation receiving warfarin (W) versus aspirin (A). Methods: In a prospective study of 312 patients (pts) (208 women and 104 men), mean age 84±7 years, with chronic atrial fibrillation, 125 pts were treated with long-term W to maintain an INR between 2.0 to 3.0 and 187 pts were treated with A 325 mg daily. The incidence of new stroke was determined in pts receiving W versus A. Follow-up was 36±17 months (range 1 to 99 months). Results: Bleeding episodes caused cessation of W in 4 of 125 pts (3%) and cessation of A in 4 of 187 pts (2%) (p not significant). In pts with prior stroke, new stroke developed in 27 of 67 pts (40%) on W and in 56 of 69 pts (81%) on A (p<0.0001, 50% reduction by W). In pts with no prior stroke, new stroke developed in 13 of 58 pts (22%) on W and in 66 or 118 pts (56%) on A (p <0.0001, 60% reduction by W). Cox regression analysis showed that pts taking W had a 76% less chance of developing a new stroke than those taking A after controlling the confounding effects of other risk factors. Conclusions: W was more effective than A in reducing the incidence of new thromboembolic stroke in older persons with atrial fibrillation. Clinical Implications: Older persons with atrial fibrillation at a high risk for developing stroke and without contraindications to W should be treated with W to maintain an INR between 2.0 to 3.0.

UR - http://www.scopus.com/inward/record.url?scp=33750276070&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33750276070&partnerID=8YFLogxK

M3 - Article

VL - 114

JO - Chest

JF - Chest

SN - 0012-3692

IS - 4 SUPPL.

ER -