The American Heart Association, the...

The American Heart Association, the American affliction Association, and the Stroke Council have released an advisory statement forward stoke prevention. "Role of Warfarin in Primary or Secondary blow Prevention" is available online at http://www.strokeassociation.org/ presenter.jhtml?identifier=3007546.

Warfarin is not superior to aspirin for preventing a secondary stroke in patients with noncardioembolic thump as reported in the Warfarin-Aspirin renewed Stroke Study (WARSS). The primary extreme point point of the WARSS trial was intermittent stroke or death from any cause within sum of two units years of blinded treatment with warfarin or aspirin. WARSS set no significant difference between the sum of two units treatment groups in recurrent ischemic blow death, or serious hemorrhage. steady in cases of so called "aspirin failure" (patients who had a affliction while taking aspirin before entering the study) warfarin was no better than aspirin in preventing returning stroke. For prevention of secondary misfortune in patients with normal heart function and periodical emphasis warfarin given to achieve any International Normalized Ratio flat is more costly and difficult to manage than aspirin.

Warfarin remains the treatment of choice for patients with nonvalvular atrial fibrillation (NVAF) with prior transient ischemic attack or attack who can take it safely, and for prefered NVAF high-risk patients for primary prevention, as well as patients with high risk of cerebral embolization associated with a cardiac valvular prosthesis frameed of synthetic materials. Patients with NVAF who take warfarin to achieve an INR range of 20 to 30 have hit reduced by 65 percent compared with no antithrombotic therapy, and by the agency of 45 percent compared with aspirin treatment. Prospective trials comparing use of warfarin to aspirin in other disorders with increased affliction risk are ongoing. Until these studies are complet and published, the present data support aspirin and/or other antiplatelet agents, rather than warfarin, as treatments of choice for greatest in quantity patients to prevent recurrent noncardioembolic stroke

COPYRIGHT 2004 American Academy of Family Physicians

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