Lower versus standard intensity oral anticoagulant therapy (OAT) in elderly warfarin-experienced patients with non-valvular atrial fibrillation

摘要: It has been observed that elderly patients with nonvalvular atrial fibrillation (NVAF) benefit from standard [an international normalised ratio (INR) goal of 2.0-3.0] oral anticoagulant treatment (OAT). The hypothesis lower-intensity anticoagulation therapy can offset the higher bleeding risk in this population never tested an 'ad hoc' clinical trial. Patients over 75 years age NVAF were randomised to receive warfarin maintain INR at 1.8 (range 1.5-2.0) or a target 2.5 2.0-3.0). There 135 low-intensity and 132 standard-intensity groups. During mean follow-up lasting 5.1 years, 59 primary outcome events (thromboembolism major haemorrhage) recorded, 24 (3.5 per 100 patient-years) group 35 (5.0 (HR=0.7, 95% CI 0.4-1.1, p=0.1). reduction endpoint was mainly due diminution bleedings (1.9 vs. 3.0 patient-years; HR=0.6, 0.3-1.2, median achieved value 1.86 2.24 (p 75) being managed clinic for stroke prevention (INR 1.5-2.0). However, further trials are needed confirm generated by present study.