Warfarin and Aspirin in Patients with Heart Failure and Sinus Rhythm Full Text
New England Journal of Medicine,  Clinical Article

Homma S et al. – Among patients with reduced left ventricular ejection fraction (LVEF) who were in sinus rhythm, there was no significant overall difference in the primary outcome between treatment with warfarin and treatment with aspirin. A reduced risk of ischemic stroke with warfarin was offset by an increased risk of major hemorrhage. The choice between warfarin and aspirin should be individualized.

Methods
  • The authors designed this trial to determine whether warfarin (with a target international normalized ratio of 2.0 to 3.5) or aspirin (at a dose of 325 mg per day) is a better treatment for patients in sinus rhythm who have a reduced left ventricular ejection fraction (LVEF).
  • The authors followed 2305 patients for up to 6 years (mean [±SD], 3.5±1.8).
  • The primary outcome was the time to the first event in a composite end point of ischemic stroke, intracerebral hemorrhage, or death from any cause.

Results
  • The rates of the primary outcome were 7.47 events per 100 patient–years in the warfarin group and 7.93 in the aspirin group (hazard ratio with warfarin, 0.93; 95% confidence interval [CI], 0.79 to 1.10; P=0.40).
  • There was no significant overall difference between the two treatments.
  • In a time–varying analysis, the hazard ratio changed over time, slightly favoring warfarin over aspirin by the fourth year of follow–up, but this finding was only marginally significant (P=0.046).
  • Warfarin, as compared with aspirin, was associated with a significant reduction in the rate of ischemic stroke throughout the follow–up period (0.72 events per 100 patient–years vs. 1.36 per 100 patient–years; hazard ratio, 0.52; 95% CI, 0.33 to 0.82; P=0.005).
  • The rate of major hemorrhage was 1.78 events per 100 patient–years in the warfarin group as compared with 0.87 in the aspirin group (P<0.001).
  • The rates of intracerebral and intracranial hemorrhage did not differ significantly between the two treatment groups (0.27 events per 100 patient–years with warfarin and 0.22 with aspirin, P=0.82).

Please login or register to follow this author.
Are you sure you want to Unfollow this Author?
► Click here to access Full Text, PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Nursing

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

Most Popular Nursing Articles

1 Long-term associations of nut consumption with body weight and obesity American Journal of Clinical Nutrition, June 23, 2014    Clinical Article

2 Yogurt and weight management American Journal of Clinical Nutrition, April 3, 2014    Review Article

3 Chocolate intake and diabetes risk Clinical Nutrition, July 21, 2014    Clinical Article

4 Metformin in chronic kidney disease: Time for a rethink Peritoneal Dialysis International, July 9, 2014    Clinical Article

5 Blood pressure in relation to coffee and caffeine consumption Current Hypertension Reports, August 8, 2014    Review Article

6 Tea consumption and leukemia risk: A meta-analysis Tumor Biology, February 12, 2014    Evidence Based Medicine    Clinical Article

7 Vitamin D and sleep disorders Full Text Nature and Science of Sleep, August 13, 2014    Free full text    Clinical Article

8 Yogurt consumption, weight change and risk of overweight/obesity: The SUN cohort study Nutrition, Metabolism & Cardiovascular Diseases, July 28, 2014    Clinical Article

9 Nut consumption for vascular health and cognitive function Nutrition Research Reviews, July 14, 2014    Review Article

10 The associations between yogurt consumption, diet quality, and metabolic profiles in children in the USA European Journal of Nutrition, July 22, 2014    Clinical Article

11 Vitamin D and the risk of dementia and Alzheimer's disease Neurology®, August 27, 2014    Clinical Article

12 Long-term coffee consumption and risk of cardiovascular disease Circulation, February 11, 2014    Evidence Based Medicine    Review Article    Clinical Article

13 Soda consumption and risk of hip fractures in postmenopausal women in the Nurses’ Health Study American Journal of Clinical Nutrition, August 18, 2014    Clinical Article

14 Effect of omega-3 fatty acids on kidney function after myocardial infarction: The Alpha Omega Trial Clinical Journal of the American Society of Nephrology, August 12, 2014    Clinical Article
Exclusive Author Commentary

15 Coffee consumption and mortality from all causes, cardiovascular disease, and cancer: a dose-response meta-analysis American Journal of Epidemiology, August 26, 2014    Evidence Based Medicine    Review Article

16 Effect of a low-flatulogenic diet in patients with flatulence and functional digestive symptoms Neurogastroenterology & Motility, February 25, 2014    Clinical Article
Exclusive Author Commentary

17 NIDA review summarizes research on marijuana's negative health effects Full Text NIH News, June 6, 2014    Free full text

18 Egg consumption is associated with increased risk of ovarian cancer: Evidence from a meta-analysis of observational studies Clinical Nutrition, August 5, 2014    Evidence Based Medicine

19 The effect of chromium supplementation on polycystic ovary syndrome in adolescents Journal of Pediatric and Adolescent Gynecology , May 30, 2014    Clinical Article

20 Vitamin D and melanoma and non-melanoma skin cancer risk and prognosis: A comprehensive review and meta-analysis European Journal of Cancer, August 7, 2014    Review Article

Indexed Journals in Nursing: Journal of Advanced Nursing, Journal of Clinical Nursing, Nurse Education In Practicemore

Register now to view all the MDLinx contents (FREE)!

  • Stay current on the latest literature, research and clinical news
  • Get special communications and offers from MDLinx and our sponsors
  • Receive invitations to paid market research
View Samples and Register

Connect with us, stay current.

Receive the latest mecial news
updates for free via email

Sign up!

Subscribe to our free RSS feeds:

Get the latest news in your specialty automatically added to your newsreader or your personal My Yahoo!, Google, My MSN or My AOL page. Learn More

Close