The effect and safety of the antithrombotic therapies in patients with atrial fibrillation and CHADS2 Score 1

Byung Ho Lee, Jae Seok Park, Jae Hyung Park, Jong Seung Park, Jae Jin Kwak, Eui Seock Hwang, Sook Kyoung Kim, Dong Hoon Choi, Young Hoon Kim, Hui Nam Pak

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Background: The revised ACC/AHA/ESC 2006 guideline recommends either aspirin or warfarin for the prevention of ischemic stroke in patients with atrial fibrillation (AF) in CHADS2 score 1. We hypothesized that warfarin is superior to aspirin therapy for the prevention of stroke without increasing bleeding complication in AF patients with CHADS2 score 1. Methods and Results: Among 1,502 patients (mean 62.4 ± 13.8 years old, male 65.4%) who were treated for nonvalvular AF without previous stroke, the number of patients with CHADS2 score 1 was 422 (62.9 ± 10.7 years old, male 290 [68.7%]) and their antithrombotic therapies were as follows: warfarin (n = 143), aspirin (n = 124), other antiplatelet (n = 45), and no antithrombosis (none: n = 110). We reviewed the incidences of ischemic stroke, mortality, and bleeding complications during the follow-up period. Results were: (1) during 22.3 ± 17.8 months of follow-up, the incidence of ischemic stroke was significantly lower in warfarin (6 patients, 4.2%, mean international normalized ratio [INR] 2.0 ± 0.5 IU) than in aspirin (16 patients, 12.9%, P = 0.008) than none (23 patients, 20.9%, P < 0.001) without differences in all-cause mortality. (2) The incidence of major bleeding (decrease in hemoglobin ≥2 g/dL, requiring hospitalization or red blood cell transfusion ≥2 pints) was not different between warfarin (2.1%) and aspirin (0.8%, P = NS), but minor bleeding was more common in warfarin (10.5%) than in aspirin (2.4%, P = 0.007). Conclusion: In AF patients with CHADS2 score 1, warfarin was better to prevent ischemic stroke than aspirin without increasing the incidence of major bleeding complications. However, the incidence of minor bleeding was higher in the warfarin group than the aspirin group.

Original languageEnglish
Pages (from-to)501-507
Number of pages7
JournalJournal of Cardiovascular Electrophysiology
Volume21
Issue number5
DOIs
Publication statusPublished - 2010 May 1

Fingerprint

Warfarin
Atrial Fibrillation
Aspirin
Safety
Stroke
Hemorrhage
Incidence
Therapeutics
Erythrocyte Transfusion
International Normalized Ratio
Mortality
Hemoglobins
Hospitalization
Guidelines

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Lee, Byung Ho ; Park, Jae Seok ; Park, Jae Hyung ; Park, Jong Seung ; Kwak, Jae Jin ; Hwang, Eui Seock ; Kim, Sook Kyoung ; Choi, Dong Hoon ; Kim, Young Hoon ; Pak, Hui Nam. / The effect and safety of the antithrombotic therapies in patients with atrial fibrillation and CHADS2 Score 1. In: Journal of Cardiovascular Electrophysiology. 2010 ; Vol. 21, No. 5. pp. 501-507.
@article{c7f84a0d67144e3881260e2e2cac2db6,
title = "The effect and safety of the antithrombotic therapies in patients with atrial fibrillation and CHADS2 Score 1",
abstract = "Background: The revised ACC/AHA/ESC 2006 guideline recommends either aspirin or warfarin for the prevention of ischemic stroke in patients with atrial fibrillation (AF) in CHADS2 score 1. We hypothesized that warfarin is superior to aspirin therapy for the prevention of stroke without increasing bleeding complication in AF patients with CHADS2 score 1. Methods and Results: Among 1,502 patients (mean 62.4 ± 13.8 years old, male 65.4{\%}) who were treated for nonvalvular AF without previous stroke, the number of patients with CHADS2 score 1 was 422 (62.9 ± 10.7 years old, male 290 [68.7{\%}]) and their antithrombotic therapies were as follows: warfarin (n = 143), aspirin (n = 124), other antiplatelet (n = 45), and no antithrombosis (none: n = 110). We reviewed the incidences of ischemic stroke, mortality, and bleeding complications during the follow-up period. Results were: (1) during 22.3 ± 17.8 months of follow-up, the incidence of ischemic stroke was significantly lower in warfarin (6 patients, 4.2{\%}, mean international normalized ratio [INR] 2.0 ± 0.5 IU) than in aspirin (16 patients, 12.9{\%}, P = 0.008) than none (23 patients, 20.9{\%}, P < 0.001) without differences in all-cause mortality. (2) The incidence of major bleeding (decrease in hemoglobin ≥2 g/dL, requiring hospitalization or red blood cell transfusion ≥2 pints) was not different between warfarin (2.1{\%}) and aspirin (0.8{\%}, P = NS), but minor bleeding was more common in warfarin (10.5{\%}) than in aspirin (2.4{\%}, P = 0.007). Conclusion: In AF patients with CHADS2 score 1, warfarin was better to prevent ischemic stroke than aspirin without increasing the incidence of major bleeding complications. However, the incidence of minor bleeding was higher in the warfarin group than the aspirin group.",
author = "Lee, {Byung Ho} and Park, {Jae Seok} and Park, {Jae Hyung} and Park, {Jong Seung} and Kwak, {Jae Jin} and Hwang, {Eui Seock} and Kim, {Sook Kyoung} and Choi, {Dong Hoon} and Kim, {Young Hoon} and Pak, {Hui Nam}",
year = "2010",
month = "5",
day = "1",
doi = "10.1111/j.1540-8167.2009.01661.x",
language = "English",
volume = "21",
pages = "501--507",
journal = "Journal of Cardiovascular Electrophysiology",
issn = "1045-3873",
publisher = "Wiley-Blackwell",
number = "5",

}

The effect and safety of the antithrombotic therapies in patients with atrial fibrillation and CHADS2 Score 1. / Lee, Byung Ho; Park, Jae Seok; Park, Jae Hyung; Park, Jong Seung; Kwak, Jae Jin; Hwang, Eui Seock; Kim, Sook Kyoung; Choi, Dong Hoon; Kim, Young Hoon; Pak, Hui Nam.

In: Journal of Cardiovascular Electrophysiology, Vol. 21, No. 5, 01.05.2010, p. 501-507.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The effect and safety of the antithrombotic therapies in patients with atrial fibrillation and CHADS2 Score 1

AU - Lee, Byung Ho

AU - Park, Jae Seok

AU - Park, Jae Hyung

AU - Park, Jong Seung

AU - Kwak, Jae Jin

AU - Hwang, Eui Seock

AU - Kim, Sook Kyoung

AU - Choi, Dong Hoon

AU - Kim, Young Hoon

AU - Pak, Hui Nam

PY - 2010/5/1

Y1 - 2010/5/1

N2 - Background: The revised ACC/AHA/ESC 2006 guideline recommends either aspirin or warfarin for the prevention of ischemic stroke in patients with atrial fibrillation (AF) in CHADS2 score 1. We hypothesized that warfarin is superior to aspirin therapy for the prevention of stroke without increasing bleeding complication in AF patients with CHADS2 score 1. Methods and Results: Among 1,502 patients (mean 62.4 ± 13.8 years old, male 65.4%) who were treated for nonvalvular AF without previous stroke, the number of patients with CHADS2 score 1 was 422 (62.9 ± 10.7 years old, male 290 [68.7%]) and their antithrombotic therapies were as follows: warfarin (n = 143), aspirin (n = 124), other antiplatelet (n = 45), and no antithrombosis (none: n = 110). We reviewed the incidences of ischemic stroke, mortality, and bleeding complications during the follow-up period. Results were: (1) during 22.3 ± 17.8 months of follow-up, the incidence of ischemic stroke was significantly lower in warfarin (6 patients, 4.2%, mean international normalized ratio [INR] 2.0 ± 0.5 IU) than in aspirin (16 patients, 12.9%, P = 0.008) than none (23 patients, 20.9%, P < 0.001) without differences in all-cause mortality. (2) The incidence of major bleeding (decrease in hemoglobin ≥2 g/dL, requiring hospitalization or red blood cell transfusion ≥2 pints) was not different between warfarin (2.1%) and aspirin (0.8%, P = NS), but minor bleeding was more common in warfarin (10.5%) than in aspirin (2.4%, P = 0.007). Conclusion: In AF patients with CHADS2 score 1, warfarin was better to prevent ischemic stroke than aspirin without increasing the incidence of major bleeding complications. However, the incidence of minor bleeding was higher in the warfarin group than the aspirin group.

AB - Background: The revised ACC/AHA/ESC 2006 guideline recommends either aspirin or warfarin for the prevention of ischemic stroke in patients with atrial fibrillation (AF) in CHADS2 score 1. We hypothesized that warfarin is superior to aspirin therapy for the prevention of stroke without increasing bleeding complication in AF patients with CHADS2 score 1. Methods and Results: Among 1,502 patients (mean 62.4 ± 13.8 years old, male 65.4%) who were treated for nonvalvular AF without previous stroke, the number of patients with CHADS2 score 1 was 422 (62.9 ± 10.7 years old, male 290 [68.7%]) and their antithrombotic therapies were as follows: warfarin (n = 143), aspirin (n = 124), other antiplatelet (n = 45), and no antithrombosis (none: n = 110). We reviewed the incidences of ischemic stroke, mortality, and bleeding complications during the follow-up period. Results were: (1) during 22.3 ± 17.8 months of follow-up, the incidence of ischemic stroke was significantly lower in warfarin (6 patients, 4.2%, mean international normalized ratio [INR] 2.0 ± 0.5 IU) than in aspirin (16 patients, 12.9%, P = 0.008) than none (23 patients, 20.9%, P < 0.001) without differences in all-cause mortality. (2) The incidence of major bleeding (decrease in hemoglobin ≥2 g/dL, requiring hospitalization or red blood cell transfusion ≥2 pints) was not different between warfarin (2.1%) and aspirin (0.8%, P = NS), but minor bleeding was more common in warfarin (10.5%) than in aspirin (2.4%, P = 0.007). Conclusion: In AF patients with CHADS2 score 1, warfarin was better to prevent ischemic stroke than aspirin without increasing the incidence of major bleeding complications. However, the incidence of minor bleeding was higher in the warfarin group than the aspirin group.

UR - http://www.scopus.com/inward/record.url?scp=77951154057&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77951154057&partnerID=8YFLogxK

U2 - 10.1111/j.1540-8167.2009.01661.x

DO - 10.1111/j.1540-8167.2009.01661.x

M3 - Article

C2 - 20021521

AN - SCOPUS:77951154057

VL - 21

SP - 501

EP - 507

JO - Journal of Cardiovascular Electrophysiology

JF - Journal of Cardiovascular Electrophysiology

SN - 1045-3873

IS - 5

ER -