Atrial fibrillation (AF), which is the most common arrhythmia and an independent risk factor for ischemic stroke, is independently associated with increased mortality. Furthermore, nonvalvular AF (that is, AF that doesn t stem from a problem with heart valves) is associated with a nearly five-fold higher risk of ischemic stroke, a risk that progressively increases with age.
In a meta-analysis involving 29 clinical studies and 28,044 patients, judicious antithrombotic therapy with adjusted-dose warfarin was shown to reduce risk related to ischemic stroke by nearly 60 percent and mortality by approximately 25 percent. Further, there were no significant increases in hemorrhagic stroke, researchers reported online in JAMA.
Led by Gautam R. Shroff, MBBS, a team of researchers identified patients with prevalent AF using the Medicare five percent database a rolling replacement cohort composed of a random sample of 5 percent of all Medicare beneficiaries over a span of 15 years.