Abstract
The benefits of long term anticoagulant treatment of patients with non-rheumatic atrial fibrillation and cerebral infarction were studied by comparing two series of patients with stroke from centres with different policies on anticoagulant treatment. The long term prognosis of 50 patients from the Oxfordshire community stroke project, who did not receive anticoagulants, was compared with that of 70 similar patients from Maastricht, who were treated with anticoagulants. After a mean follow up of 27 months there was no significant difference in either the rate of survival or the rate of recurrent stroke between the two groups.
These data suggest that any benefit of anticoagulation is modest. A large randomised trial is planned to establish whether long term anticoagulant treatment is of value and, if so, to what extent.
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Selected References
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- Furlan A. J., Cavalier S. J., Hobbs R. E., Weinstein M. A., Modic M. T. Hemorrhage and anticoagulation after nonseptic embolic brain infarction. Neurology. 1982 Mar;32(3):280–282. doi: 10.1212/wnl.32.3.280. [DOI] [PubMed] [Google Scholar]
- Hachinski V. Atrial fibrillation and recurrent stroke. Arch Neurol. 1986 Jan;43(1):70–70. doi: 10.1001/archneur.1986.00520010064025. [DOI] [PubMed] [Google Scholar]
- Kelley R. E., Berger J. R., Alter M., Kovacs A. G. Cerebral ischemia and atrial fibrillation: prospective study. Neurology. 1984 Oct;34(10):1285–1291. doi: 10.1212/wnl.34.10.1285. [DOI] [PubMed] [Google Scholar]
- Koller R. L. Recurrent embolic cerebral infarction and anticoagulation. Neurology. 1982 Mar;32(3):283–285. [PubMed] [Google Scholar]
- Lodder J., van der Lugt P. J. Evaluation of the risk of immediate anticoagulant treatment in patients with embolic stroke of cardiac origin. Stroke. 1983 Jan-Feb;14(1):42–46. doi: 10.1161/01.str.14.1.42. [DOI] [PubMed] [Google Scholar]
- Martin G. J., Biller J. Nonseptic cerebral emboli of cardiac origin. Arch Intern Med. 1984 Oct;144(10):1997–1999. [PubMed] [Google Scholar]
- Pessin M. S., Hinton R. C., Davis K. R., Duncan G. W., Roberson G. H., Ackerman R. H., Mohr J. P. Mechanisms of acute carotid stroke. Ann Neurol. 1979 Sep;6(3):245–252. doi: 10.1002/ana.410060311. [DOI] [PubMed] [Google Scholar]
- Peto R., Pike M. C., Armitage P., Breslow N. E., Cox D. R., Howard S. V., Mantel N., McPherson K., Peto J., Smith P. G. Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. analysis and examples. Br J Cancer. 1977 Jan;35(1):1–39. doi: 10.1038/bjc.1977.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sage J. I., Van Uitert R. L. Risk of recurrent stroke in patients with atrial fibrillation and non-valvular heart disease. Stroke. 1983 Jul-Aug;14(4):537–540. doi: 10.1161/01.str.14.4.537. [DOI] [PubMed] [Google Scholar]
- Sandercock P., Warlow C., Bamford J., Peto R., Starkey I. Is a controlled trial of long-term oral anticoagulants in patients with stroke and non-rheumatic atrial fibrillation worthwhile? Lancet. 1986 Apr 5;1(8484):788–792. doi: 10.1016/s0140-6736(86)91794-0. [DOI] [PubMed] [Google Scholar]
- Sherman D. G., Hart R. G., Easton J. D. The secondary prevention of stroke in patients with atrial fibrillation. Arch Neurol. 1986 Jan;43(1):68–70. doi: 10.1001/archneur.1986.00520010062024. [DOI] [PubMed] [Google Scholar]
- Starkey I., Warlow C. The secondary prevention of stroke in patients with atrial fibrillation. Arch Neurol. 1986 Jan;43(1):66–68. doi: 10.1001/archneur.1986.00520010060023. [DOI] [PubMed] [Google Scholar]
- Yusuf S., Peto R., Lewis J., Collins R., Sleight P. Beta blockade during and after myocardial infarction: an overview of the randomized trials. Prog Cardiovasc Dis. 1985 Mar-Apr;27(5):335–371. doi: 10.1016/s0033-0620(85)80003-7. [DOI] [PubMed] [Google Scholar]
