Journal article
WARFARIN COMPARED TO ASPIRIN FOR PREVENTION OF ARTERIAL THROMBOEMBOLISM IN ATRIAL-FIBRILLATION - DESIGN AND PATIENT CHARACTERISTICS OF THE STROKE PREVENTION IN ATRIAL FIBRILLATION-II STUDY
Cerebrovascular diseases (Basel, Switzerland), Vol.2(6), pp.332-341
11/01/1992
DOI: 10.1159/000109040
Abstract
Recent clinical trials have established that warfarin is highly effective in reducing ischemic stroke in patients with nonvalvular atrial fibrillation, but the relative value of aspirin compared to warfarin is less clear. We report the rationale and design of the second phase of the Stroke Prevention in Atrial Fibrillation (SPAF II) Study. The SPAF II Study compares warfarin (adjusted to prolong the prothrombin time ratio 1.3-1.8 times control or INR 2-4.5) to aspirin (325 mg/day) in a randomized clinical trial involving 1,100 patients at 16 centers. Medications are not administered in a blind fashion; primary events (all ischemic strokes and systemic emboli) are verified by an Events Verification Committee who has no knowledge of treatment allocation. We hypothesize that aspirin may be inadequately effective in patients over age 75 years and that warfarin may be more toxic in these elderly patients. Consequently, the primary analyses of the SPAF II Study compare the effect of antithrombotic therapies separately in patients less-than-or-equal-to 75 years old (n = 715) and in patients > 75 years old (n = 385). All patients have been entered and final results are expected in 1993. The mean patient age is 64 years in the younger group and 80 years in the older group. Patients over age 75 years are more often women (p < 0.001) with more associated cardiovascular disease, including a higher mean systolic blood pressure (p < 0.001) and more frequent histories of congestive heart failure (p = 0.001) and coronary artery disease (p = 0.01). We anticipate that aspirin prophylaxis for the primary prevention of thromboembolism may be adequate for many, perhaps most, patients with nonvalvular atrial fibrillation and hope to define the subset of the patients who require chronic anticoagulation to prevent stroke.
Details
- Title: Subtitle
- WARFARIN COMPARED TO ASPIRIN FOR PREVENTION OF ARTERIAL THROMBOEMBOLISM IN ATRIAL-FIBRILLATION - DESIGN AND PATIENT CHARACTERISTICS OF THE STROKE PREVENTION IN ATRIAL FIBRILLATION-II STUDY
- Creators
- D C AndersonR W AsingerS M NewburgS. R BundlieC C FarmerR L KollerJ M HauglandM A NanceR M TarrelD N DunbarC R JorgensenS W SharkeyG C FlakerR WebelB NolteP StevensonJ ByerW WrightJ H ChesebroD O WiebersA E HollandS LeeW T BardsleyS KopeckyS C LitinI MeissnerD M ZerbeJ H McanultyC MarchantB M CoullG FeldmanA HaywardK MacmillanE GandaraN BlankA D LeonardM C KanterD SolomonM ZabalgoitiaW R LoganW P HamiltonB J GreenR S BaconD L JanosikD J CadellL KellermanC R GomezA J LabovitzR E KelleyR ChahineM PalermoP TeixeiroW M FeinbergB K VoldK B KernC AppletonV T MillerC J HockersmithB A CohenJ L HalperinE B RothlaufJ M WeinbergerM E GoldmanH C DittrichJ F RothrockC HagenhoffC M HelgasonG T KondosJ HoffR R RabjohnsR P McraeJ GhaliR M RothbartG H BaileyC BurkhardtL HorwitzJ L BlackshearL WeaverV BakerG LeeG LaneF RubinoR StaffordR McbrideL PearceK FossumE NascoR G HartD G ShermanR L TalbertT L DacyP A HeberlingJ L HalperinR G HartT ColtonD E LevyJ D MarshKMA WelchJ R MarlerM D Walker
- Resource Type
- Journal article
- Publication Details
- Cerebrovascular diseases (Basel, Switzerland), Vol.2(6), pp.332-341
- Publisher
- Karger
- DOI
- 10.1159/000109040
- ISSN
- 1015-9770
- eISSN
- 1421-9786
- Number of pages
- 10
- Language
- English
- Date published
- 11/01/1992
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984657733502771
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