warfarin
DISEASE INTERVENTION COMPARISON RESULTS
Arch Intern Med. 1999 Apr 12;159(7):677-85 Decision Model
IN atrial fibrillation, elderly patients The Use of
warfarin
As Treatment, Chronic
Is better Than
aspirin or no treatment
To increase, in patients with average risk of stroke, expected QALYs: 12.9 warfarin, 11.2 aspirin and 10.15 no Tt.
J Am Geriatr Soc. 2002 May;50(5):863-9 Decision Model
IN atrial fibrillation, elderly patients The Use of
warfarin, anticoagulants
As Treatment, Chronic
Is equal Than
aspirin or no treatment
To increase expected QALYs: no compelling evidence of gain in quality-adjusted life expectancy with anticoagulation.
Lancet. 2007 Aug 11;370(9586):493-503 Randomized Controlled Trial, Multicenter Study
IN atrial fibrillation, elderly patients, not high haemorrahgic risk, noT high stroke risk, anticoagulants, vitamin K antagonists, bleeding risk, elder patients The Use of
vitamin K antagonists, warfarin
As Treatment, Chronic
Is better Than
aspirin
To reduce all-type strokes: 1.8% warfarin versus 3.8% aspirin. No increase at all in major haemorrhages.
Lancet. 2000 Mar 18;355(9208):956-62 Decision Model
IN atrial fibrillation, embolic complications The Use of
vitamin K antagonists, warfarin
As Treatment, Chronic
Is better Than
aspirin or placebo
To reduce stroke and parterial embolism for most patients, specially those older
Heart. 2008 Dec;94(12):1607-13 Meta-Analysis
IN atrial fibrillation, embolic complications, systemic non-cerebral embolism The Use of
vitamin K antagonists, warfarin
As Treatment, Chronic
Is better Than
placebo or antiplatelet agents, aspirin
To reduce systemic embolism: OR 0.5 VS aspirin, OR 0.7 VS placebo. Increased major bleeding: OR 3 VS placebo.
Cochrane Database Syst Rev. 2007;(3):CD006186 Systematic Review, Cochrane Review
IN atrial fibrillation, non valvular, stroke, ischemic, cerebral infarction, embolic The Use of
vitamin K antagonists, warfarin
As Treatment, Chronic
Is better Than
aspirin
To reduce all stroke (OR 0.68) and systemic emboli (OR 0.48) but increasing intracranial haemorrhage (OR 1.98). No modification of mortality.
Cochrane Database Syst Rev. 2005 Jul 20;(3):CD001927 Systematic Review, Cochrane Review
IN atrial fibrillation, non valvular, stroke, ischemic, cerebral infarction, embolic The Use of
vitamin K antagonists, warfarin
As Treatment, Chronic
Is better Than
placebo or no treatment at all
To reduce all strokes (ARR 2.5% per year), reduce disabling or fatal stroke (ARR 1.2% per year) and reduce death (OR 0.69)
Ann Intern Med. 2009 Sep 1;151(5):297-305 Cohorts
IN atrial fibrillation, non-valvular The Use of
vitamin K antagonists, warfarin
As Treatment, Chronic
Is better Than
aspirin or no treatment
To obtain an average net clinical benefit of 0.68% per year, which was greater the higher the embolic risk was, icluding elderly patients
Circulation. 2004 Mar 30;109(12):1509-13 Cohorts
IN atrial fibrillation, persistent, rate control strategy The Use of
warfarin use, recovering and maintaining sinus rhythm (either reciving rate or rhythm control management)
As Prognostic Item
Is better Than
not receiving warfaring or resting in atrial fibrillation
To predict a reduced mortality. However, no association of the administration of rate or rhythm control or antiarrhythmics with changes in mortality.
JAMA. 2002 Nov 20;288(19):2441-8 Meta-Analysis
IN atrial fibrillation, stroke, ischemic, cerebral infarction, embolic The Use of
vitamin K antagonists, warfarin
As Treatment, Chronic
Is better Than
aspirin
To decrease stroke (of any type): 2.4% per year with warfarin VS. 4.5% with aspirin. But modestly increased major bleeding: 2.2 VS. 1.3% per year. Overall all-cause mortality did not differ
Ann Intern Med. 2007 Jun 19;146(12):857-67 Systematic Review
IN atrial fibrillation, stroke, ischemic, cerebral infarction, embolic The Use of
vitamin K antagonists, warfarin
As Treatment, Chronic
Is better Than
aspirin
To reduce stroke (any type) rates: by 60% warfarin VS by 20% reduction with aspirin. Increases in major extracranial hemorrhage <= 0.3% per year)
Arch Intern Med. 2005 May 23;165(10):1185-91 Randomized Controlled Trial, Multicenter Study
IN atrial fibrillation, stroke, ischemic, cerebral infarction, embolic The Use of
vitamin K antagonists, warfarin
As Treatment, Chronic
Is better Than
aspirin or no treatment
To prevent stroke (69% relative risk decrease with warfarin)
Arch Intern Med. 2006 Jun 26;166(12):1269-75 Systematic Review
IN stroke, ischemic, cerebral infarction, embolic, atrial fibrillation The Use of
standard dose and low dose vitamin K antagonists, warfarin, ximelagatran, antiplatelet drugs, aspirin
As Treatment, Chronic
Is better Than
placebo
To prevent stroke (all types): standard-dose warfarin could prevent 28 ischemic strokes at the expense of 11 major bleedings, aspirin prevent 16 strokes with 6 major bleedings.