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Paper Information

Journal:   KOWSAR MEDICAL JOURNAL   Summer 2004 , Volume 9 , Number Part 2; Page(s) 135 To 142.
 
Paper: 

EFFECTIVENESS OF FIXED MINIDOSE WARFARIN IN THE PREVENTION OF THROMBOEMBOLISM IN PATIENTS WITH NONVALVULAR ATRIAL FIBRILLATION

 
 
Author(s):  NOUGH H.*, NOUGH JAVAZAM M.
 
* 
 
Abstract: 
Objective. Nonvalvular atrial fibrillation (AF) is the most common cause of cardioembolic stroke. Anticogulation with warfarin is highly effective for reducing of stroke, but risk of bleeding is high specially among the elderly, also there is a need for frequent clinical and laboratory monitoring.
Materials and Methods. In this study patients between 45-75 years with nonvalvular AF were selected in an open labeled trial in respect of ability to take warfarin with standard adjusted dose (adjusted - dose group, INR 2-3) and inability to take (fixed minidose 1.25 mg/day warfarin). The outcome was ischemic stroke, visceral or peripheral emboli, major bleeding and vascular death. During a 38 months period, from a total of 187 considered patients, 151 were selected to be studied, (72 in adjusted dose group and 79 in fixed minidose group). Mean follow up was 18.5 months.
Results. Total outcome rate was 8.3% in adjusted dose group and 5.6% in fixed mindose group. The rate of major bleeding due to warfarin was significantly higher in adjusted - dose group (4.2% VS 0%, P<0.02).
The rate of cardioembolic event and vascular death was 1.3% in the adjusted - dose group and 2.6% in fixed minidose group, that was not significant statistically.
Conclusion. In this study, there was no significant diference between two groups rate of cardioembolic event and stroke, this suggest that fixed minidose warfarin is effective in the prevention of thromboembolic event in patients with non valvular AF and also has a lower risk of major bleeding due to warfarin.
 
Keyword(s): MINIDOSE WARFARIN, NONVALVULAR AF, THROMBOEMBOLISM
 
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