Table 4:

Physicians fear

Most of the physicians fear is not founded on sound evidence. The absolute risk of warfarin associated intra cranial haemorrhge in patients with NVAF is relatively low at 0.2% per year and only 35% of these are fatal. The risk of major hemorrhage is similar among older people (≥75 years) with NVAF receiving warfarin or aspirin. Quality of anticoagulation control is a more detrimental factor for bleeding rather than age. Physician’s attitude and decision for anticoagulation use seems to be affected more by observing a bleeding rather than a thromboembolic event. Oral anticoagulation in NVAF patients who are prone to falls and have multiple additional stroke risk factors appears to have an overall net clinical benefit in spite of the falls risk. Cognitive dysfunction has no direct relation with bleeding or thrombotic events. Patient education about oral anticoagulation therapy is associated with better outcomes.