Current Trial-Associated Outcomes With Warfarin in Prevention of Stroke in Patients With Nonvalvular Atrial Fibrillation Full Text
JAMA Internal Medicine,  Evidence Based Medicine  Clinical Article

Agarwal S et al. – Current use of warfarin as a stroke prevention agent in patients with atrial fibrillation (AF) is associated with a low rate of residual stroke or systemic embolism estimated to be 1.66% per year. Compared with a previous meta–analysis, there has been significant improvement in the proportion of time spent in therapeutic anticoagulation, with a resultant decline in observed stroke rates.

Methods
  • The authors searched the MEDLINE, EMBASE, and Cochrane databases for relevant studies; RCTs comparing warfarin with an alternative thromboprophylaxis strategy with at least 400 patients in the warfarin arm and reporting stroke as an efficacy outcome were included.

Results
  • Eight RCTs with 55 789 patient–years of warfarin therapy follow–up were included.
  • Overall time spent in the therapeutic range was 55% to 68%.
  • The annual incidence of stroke or systemic embolism in patients with AF taking warfarin was estimated to be 1.66% (95% CI, 1.41%–1.91%).
  • Major bleeding rates varied from 1.40% to 3.40% per year across the studies.
  • The risk of stroke per year was significantly higher in elderly patients (2.27%), female patients (2.12%), patients with a history of stroke (2.64%), and patients reporting no previous exposure to vitamin K antagonists (1.96%).
  • There was a significant increase in the annual incidence of stroke with progressively increasing CHADS2 (congestive heart failure, hypertension, age, diabetes, and prior stroke) scores.

Please login or register to follow this author.
► Click here to access Full Text, PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Nurse Practitioner

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Nurse Practitioner Articles

1 Chocolate intake and diabetes risk Clinical Nutrition, October 27, 2014    Clinical Article

2 Association of daily coffee and tea consumption and metabolic syndrome: results from the Polish arm of the HAPIEE study European Journal of Nutrition, November 21, 2014    Clinical Article

3 Consumption of garlic and risk of colorectal cancer: An updated meta-analysis of prospective studies Full Text World Journal of Gastroenterology, November 18, 2014    Free full text    Evidence Based Medicine

4 Dietary flavonoid intake at midlife and healthy aging in women American Journal of Clinical Nutrition, November 7, 2014    Clinical Article

5 The impact of patient suicide and sudden death on health care professionals General Hospital Psychiatry, October 27, 2014    Clinical Article
Exclusive Author Commentary

6 Vitamin D deficiency predicts cognitive decline in older men and women: The Pro.V.A. Study Neurology®, November 19, 2014    Clinical Article

7 Dairy product consumption and gastric cancer risk: A meta-analysis Full Text World Journal of Gastroenterology, November 14, 2014    Free full text    Evidence Based Medicine

8 Coffee for morning hunger pangs. An examination of coffee and caffeine on appetite, gastric emptying, and energy intake Appetite, October 17, 2014    Clinical Article

9 The effect of music therapy on cognitive functioning among older adults: a systematic review and meta-analysis Journal of the American Medical Directors Association, November 25, 2014    Evidence Based Medicine    Review Article

10 Fish consumption and risk of gastrointestinal cancers: A meta-analysis of cohort studies Full Text World Journal of Gastroenterology, November 17, 2014    Free full text    Evidence Based Medicine

11 Multivitamin use and cardiovascular disease in a prospective study of women American Journal of Clinical Nutrition, November 24, 2014    Clinical Article

12 Vegetarian diets and glycemic control in diabetes: A systematic review and meta-analysis Full Text Cardiovascular Diagnosis and Therapy, November 20, 2014    Free full text    Evidence Based Medicine    Review Article

13 Fruit and vegetable intake and rate of heart failure: A population-based prospective cohort of women European Journal of Heart Failure, November 12, 2014    Clinical Article

14 Results of 2-year vitamin B treatment on cognitive performance: Secondary data from an RCT Neurology®, November 21, 2014    Clinical Article

15 Milk intake and risk of mortality and fractures in women and men: cohort studies BMJ, November 11, 2014    Evidence Based Medicine    Clinical Article

16 Vitamin D and pregnancy outcomes Current Opinion in Obstetrics and Gynecology, November 14, 2014    Review Article

17 Dairy products, calcium, and prostate cancer risk: A systematic review and meta-analysis of cohort studies American Journal of Clinical Nutrition, November 26, 2014    Clinical Article

18 Rheological characteristics of cold thickened beverages containing xanthan gum–based food thickeners used for dysphagia diets Journal of the Academy of Nutrition and Dietetics, November 24, 2014    Clinical Article

19 Vitamin and mineral supplements The Journal of the American Dental Association , November 3, 2014    Evidence Based Medicine    Clinical Article

20 The low-FODMAP diet: An approach for controlling irritable bowel syndrome Topics in Clinical Nutrition, November 21, 2014    Clinical Article

Indexed Journals in Nurse Practitioner: Journal of the American Academy of Nurse Practitioners, Holistic Nursing Practicemore