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abstractA comparison of the risks and benefits of warfarin and acetylsalicylic acid in preventing thromboembolic stroke in the very old with chronic or paroxysmal atrial fibrillation leans towards the former.
A vast number of studies have been carried out on this subject, all of them in the 1990s. The most reliable of these, in terms of methodology and representativeness of the sample was SPAF III, published in the Lancet in 1996. It considered 1044 patients in 20 centres across North America with a thromboembolic risk increased by additional pathological conditions or aged over 75. The study found that in adequate doses, warfarin reduces all ischemic strokes from 7.9 to 1.7 percent per year, and fatal or debilitating strokes from 5.6 to 1.7 percent per year. Furthermore, there is no significant increase in the risk of haemorrhage. |
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