Warfarin Prevention of Thromboembolism in Patients With Non-rheumatic Atrial Fibrillation

Objective To compare the effect of warfarin and aspirin in preventing thromboembolism in non-valvular atrial fibrillation(AF)patients.Methods The initial dose of warfarin group is 2.0 mg/d,adjusting the dose of warfarin and making the international normalized ratio(INR)stable in 2.0~3.0.The dose of aspirin group is 150 mg qd and the patients are given conventional out-patient follow-ups.The primary endpoint events are ischemic stroke and death,and secondary endpoint events include peripheral arterial thrombosis,transient ischemic attack,asymptomatic cerebral infarction,acute myocardial infarction and severe bleeding. Results The study includes 244 cases,122 cases in each group and given an average follow-up 21(3 to 24)months.Compared with aspirin,warfarin greatly decreased the rate of the primary endpoint events(3.3%vs10.7%,P0.05),the relative risk dropped 69.2%,ischemic stroke relative risk dropped 69.5%,the relative risk of thromboembolism events dropped 71.3%,and the rate of jointend incident was significantly lowered(9.8%vs.22.1%,P0.01). The total tate of bleeding in warfarin group was significantly higher than that in aspirin group(9.8%vs2.5%,P0.05). Conclusions Compared with aspirin,warfarin can effectively reduce the rate of thromboembolim in non-valvular atrial fibrillation patients,although the rate of bleeding is higher than that of aspirin group.Warfarin is till safe and effective if INR carefully monitored.