Warfarin needed for AF with moderate stroke risk

PATIENTS with atrial fibrillation (AF) at either high or moderate risk of stroke should be treated with anticoagulants because their bleeding risk is similar, experts say.

Italian researchers prospectively followed up > 3000 patients with AF on warfarin for primary stroke prevention, showing that bleeding and stroke risk were closely correlated and were both low among low-risk patients.

However, bleeding rates did not differ for patients classed as moderate or high risk, at around 1.3 per 100 patients per year.

Stroke risk was measured using the CHADS2 score, which includes congestive heart failure, hypertension, age ≥ 75, diabetes, and previous stroke or transient ischaemic attack.

The authors suggested moderate and high-risk patients be classified as a single category that would benefit from more aggressive antithrombotic treatment.

“These patients have a similar bleeding risk and therefore the risk/benefit ratio