In patients with atrial fibrillation (AF), what is the recommended treatment to prevent stroke?
Multiple randomized controlled trials have demonstrated that the use of long-term antithrombotic therapy with warfarin or aspirin reduces the relative risk of stroke caused by AF by approximately 65 percent and 20 percent, respectively. Unfortunately, multiple studies, including those performed in long-term care settings, have shown that among older people with AF who have a moderate to high risk of stroke and no contraindications, only about 50 percent receive warfarin. Despite the real and perceived disadvantages of warfarin use for patients, facilities, and practitioners, it must be remembered that of all age groups, people over age 65 are at the highest risk of stroke due to AF. In other words, older people with AF have the most to gain from anticoagulant therapy.
