Antiplatelet therapy for patients with non-valvular atrial fibrillation and no previous history of stroke or transient ischemic attacks

Aspirin modestly (by about 20%) reduces stroke and major vascular events in nonvalvular atrial fibrillation. If the average stroke rate is 4.5%/year, the NNT for preventing one stroke during one year with aspirin is 100.

A Cochrane review (abstract , review ) included 3 trials with a total of 1 965 AF with no prior stroke or TIA. The trials tested aspirin in dosages ranging from 75 mg to 325 mg per day and 125 mg every other day to placebo (in two trials) or control (in one trial). The mean duration of follow up was 1.3 years. Aspirin was associated with nonsignificantly lower risk of ischaemic stroke (OR = 0.70, 95% CI 0.46 to 1.07), all stroke (OR = 0.70, 95% CI 0.47 to 1.07), all disabling or fatal stroke (OR 0.86, 95% CI 0.50 to 1.49) and all-cause death (OR 0.75, 95% CI 0.54 to 1.04). The combination of stroke, myocardial infarction or vascular death was significantly reduced (OR 0.71, 95% CI 0.51 to 0.97 ). No increase in intracranial hemorrhage or major extracranial hemorrhage was observed.

Ədəbiyyat

1. Aguilar M, Hart R. Antiplatelet therapy for preventing stroke in patients with non-valvular atrial fibrillation and no previous history of stroke or transient ischemic attacks. Cochrane Database Syst Rev 2005 Oct 19;(4):CD001925.