Hart et al described the risk of ischemic stroke for patients receiving aspirin therapy for atrial fibrillation. This information can help determine if alternative therapy may be more appropriate. The authors are from multiple institutions participating in the Stroke Prevention in Atrial Fibrillation (SPAF) clinical trials.
Patient selection: atrial fibrillation AND aspirin therapy
Outcome: ischemic stroke
Parameters:
(1) history of previous cerebrovascular accident (CVA) or transient ischemic attack (TIA)
(2) gender
(3) age
(4) hypertension
(5) systolic blood pressure (SBP) in mm Hg
(6) diabetes
|
History TIA or CVA |
Gender |
Age |
Comorbid |
Annual Rate of Stroke |
|
Yes |
NA |
NA |
NA |
13% |
|
No |
female |
> 75 yo |
normotensive |
7.8% |
|
No |
NA |
> 75 yo |
hypertension |
5.0% |
|
No |
NA |
> 75 yo |
hypertension plus other risk factors |
6.9% |
|
No |
male |
> 75 yo |
normotensive |
1.2% |
|
No |
NA |
NA |
SBP > 160 mm Hg |
7.2% |
|
No |
NA |
<= 75 yo |
hypertension AND diabetes |
3% |
|
No |
NA |
<= 75 yo |
hypertension |
2.6% |
|
No |
NA |
NA |
diabetes |
2.6% |
|
No |
NA |
NA |
none |
0.9% |
from Table page 2902 Stern et al, Table 4 page 1226 Hart et al.
where:
• Alcohol use at >= 14 drinks per week was associated with reduced risk of ischemic stroke (Table 3, Hart et al)
|
Annual Rate |
Risk Category |
|
13% |
very high |
|
5 to 8% |
high |
|
2 to 3% |
moderate |
|
1% |
low |
Specialty: Hematology Oncology, Neurology, Clinical Laboratory, Pharmacology, clinical
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