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Among the patients with no history of stroke,cerebral infarction occurred in 19 of the 265 patients in the placebo group during an average follow-up of 1.7 years(4.3 percent per year)and in 4 of the 260 patients in the warfarin group during an average follow-up of 1.8 years(0.9 percent per year).The reduction in risk with warfarin therapy was 0.79(95 percent confidence interval,0.52 to 0.90;P=0.001).The annual event rate among the 228 patients over 70 years of age was 4.8 percent in the placebo group and 0.9 percent in the warfarin group(risk reduction,0.79;P=0.02).The only cerebral hemorrhage occurred in a 73-year-old patient in the warfarin group.Other major hemorrhages,all gastrointestinal,occurred in 10 patients;4 in the placebo group,for a rate of 0.9 percent per year,and 6 in the warfarin group,for a rate of 1.3 percent per year.There were 37 deaths that were not preceded by a cerebral end point-22 in the placebo group and 15 in the warfarin group(risk reduction,0.31;P=0.19).Cerebral infarction was more common among patients with a history of cerebral infarction(9.3 percent per year in the placebo group and 6.1 percent per year in the warfarin group)than among those without such a history.Low- intensity anticoagulation with warfarin prevented cerebral infarction in patients with nonrheumatic atrial fibrillation without producing an excess risk of major hemorrhage.This benefit extended to patients over 70 years of age. |
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anticoagulant,treatment
anticoagulant,treatment in CVD
atrial fibrillation
cerebral embolism
cerebral embolism,cardiac origin
cerebrovascular accident
cerebrovascular accident,prevention of
coumarin
embolism
treatment of neurologic disorder
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