Abstract

Objective: To compare the therapeutic warfarin and aspirin efficacies for treatments of atrial fibrillation (AF) complicated with stable coronary heart disease particularly in older Chinese patients. Methods: In our prospective study 101 patients with AF and stable coronary heart disease older than 80 years were randomized into two groups. One group (n = 51) basically received 1.25 mg/day warfarin per os, followed by addition of 0.5 – 1.0 mg/day from day 3 – 5 if the international normalized ratio (INR) was initially < 1.5 and in order to achieve a maintained INR between 1.6 and 2.5 (warfarin group). The second group (n = 50) received 100 mg aspirin per day (control group). All patients were medicated and monitored for a period of 2 years. The primary endpoint was the occurrence of ischemic stroke or systemic embolism, and the composite secondary endpoint was non-fatal myocardial infarction and all causes of death. For safety evaluation, the hemorrhage rates were recorded. Results: The warfarin medication was superior regarding the overall occurrence of ischemic stroke or systemic embolism as well as non-fatal myocardial infarction and all causes of death outcomes compared to aspirin administration during the 2 years of medication (17.6% vs. 36.0%, p = 0.03), while there was no significant difference of mild (5 vs. 4), severe (2 vs. 1), and fatal (1 vs. 1) hemorrhage incidences between the warfarin and aspirin groups (p > 0.05). Conclusion: Warfarin was found to be more efficacious than aspirin for an anticoagulation therapy of older Chinese patients with AF and stable coronary heart disease.

Author Details

Authors

• Xinbing Liu¹
• Hongman Huang¹
• Jianhua Yu¹
• Guoliang Cao²
• Liuliu Feng¹
• Qitan Xu¹
• Shufu Zhang¹
• Mingcheng Zhou³
• Yigang Li⁴

Departments

• ¹ Department of Cardiology, Shanghai Shi Dong Hospital,
• ² Department of Geriatrics, Shanghai No.
• ³  People’s Hospital,
• ³ Department of Cardiology, An Tu Hospital, and
• ⁴ Department of Cardiology, Xin Hua Hospital, Shanghai, China

Address

Mingcheng Zhou
Department of Cardiology, An Tu Hospital
No. 200 Yanji East Road, Shanghai, 200093, China
Email: [email protected]

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