A randomised controlled trial of warfarin versus aspirin for stroke prevention in octogenarians with atrial fibrillation (WASPO)

Age and Ageing

Volumn 36, Issue 2, 2007, Pages 151-156

  Rash, Amar ^a   Downes, Tom ^a   Portner, Robin ^b   Yeo, Wilf W ^b   Morgan, Nicolette ^a   Channer, Kevin S ^b  

^a NORTHERN GENERAL HOSPITAL   (United Kingdom)

^b ROYAL HALLAMSHIRE HOSPITAL   (United Kingdom)

Author keywords

Anti coagulation; Atrial fibrillation; Elderly; Low dose asprin; Randomised controlled trial; Stroke prevention; Thromboprophylaxis; Tolerability; Warfarin

Indexed keywords

ACETYLSALICYLIC ACID; WARFARIN;

AGED; ANTICOAGULATION; ARTICLE; BLEEDING; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; DRUG DOSE COMPARISON; DRUG DOSE REDUCTION; DRUG EFFICACY; DRUG FATALITY; DRUG TOLERABILITY; DRUG WITHDRAWAL; EPISTAXIS; FEMALE; FOLLOW UP; GASTROINTESTINAL SYMPTOM; GERIATRIC CARE; HEART ATRIUM FIBRILLATION; HEMATURIA; HUMAN; MAJOR CLINICAL STUDY; MALE; MOBILIZATION; MORTALITY; OPEN STUDY; PRIMARY PREVENTION; PRIORITY JOURNAL; PROSPECTIVE STUDY; RANDOMIZED CONTROLLED TRIAL; SCORING SYSTEM; STROKE; THROMBOEMBOLISM; TREATMENT OUTCOME;

AGED, 80 AND OVER; ANTICOAGULANTS; ASPIRIN; ATRIAL FIBRILLATION; CEREBROVASCULAR DISORDERS; FEMALE; FIBRINOLYTIC AGENTS; HUMANS; MALE; PLATELET AGGREGATION INHIBITORS; WARFARIN;

EID: 33947413877     PISSN: 00020729     EISSN: 14682834     Source Type: Journal    
DOI: 10.1093/ageing/afl129     Document Type: Article

References (36)

1. Feinberg WL, Blackshear JL, Laupacis A, Kronmal RA, Hart RG. Prevalence, age distribution and gender of patients with atrial fibrillation. Arch Intern Med 1995; 155: 469-73.
2. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: The Framingham Study. Stroke 1991; 22: 983-88.
3. Petersen P, Boysen G, Godtfredsen J, Andersen ED, Andersen B. Placebo controlled, randomised trial of warfarin and aspirin for prevention of thromboembolic complications in chronic atrial fibrillation: The Copenhagen AFASAK Study. Lancet 1989; 1: 175-79.
4. Boston Area Anticoagulation Trial for Atrial Fibrillation Investigators. The effect of low dose warfarin on the risk of stroke in non-rheumatic atrial fibrillation. N Engl J Med 1990; 323: 1505-11.
5. Connolly SJ, Laupacis A, Gent M, Roberts RS, Cairns JA, Joyner C, CAFA Study Co-Investigators. Canadian Atrial Fibrillation Anticoagulation (CAFA) Study. J Am Coll Cardiol 1991; 18: 349-55.
6. Stroke Prevention in Atrial Fibrillation Investigators. The stroke prevention in atrial fibrillation study: Final results. Circulation 1991; 84: 527-39.
7. Veterans Affairs Stroke Prevention in Non-Rheumatic Atrial Fibrillation Investigators. Warfarin in the prevention of stroke associated with non-rheumatic atrial fibrillation. N Engl J Med 1992; 327: 1406-12.
8. The Stroke Prevention in Atrial Fibrillation Investigators. Bleeding during antithrombotic therapy in patients with atrial fibrillation. Arch Intern Med 1996; 156: 409-16.
9. Fihn MD, Callahan CM, Martin DC et al. The risk for and severity of bleeding complications in elderly patients treated with warfarin. Ann Intern Med 1996; 124: 970-79.
10. Gallagher MM, Camm AJ. Long-term management of atrial fibrillation. Clin Cardiol 1997; 20: 381-90.
11. Mead GE, Wardlaw JM, Lewis SC, McDowall M, Dennis MS. The influence of randomised trials on the use of anticoagulants for atrial fibrillation. Age Ageing 1999; 28: 441-46.
12. Protheroe J, Fahey T, Montgomery AA, Peters TJ. The impact of patients' preferences on the treatment of atrial fibrillation: Observational study of patient based decision analysis. BMJ 2000; 320: 1380-84.
13. Morton JA, Newton J, Gray CS. Counting the true cost of antiplatelet therapy for stroke prevention. Age Ageing 2005; 34: 212-14.
14. Oates A, Jackson PR, Austin CA, Channer KS. A new regimen for starting warfarin therapy in outpatients. Br J Clin Pharmacol 1998; 46: 157-61.
15. Office for National Statistics. Deaths, 1989-1999: Age-Specific Death Rates as a Percentage of Rates in 1989, England and Wales, June 2000, Data Set HSQ6DF1 6/6/00.
16. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation: A major contributor to stroke in the elderly. Arch Intern Med 1987; 147: 1561-64.
17. Stroke Prevention in Atrial Fibrillation Investigators. Warfarin versus aspirin for prevention of thromboembolism in atrial fibrillation: Stroke Prevention in Atrial Fibrillation II Study. Lancet 1994; 343: 687-91.
18. EAFT Study Group. European Atrial Fibrillation: Secondary prevention of vascular events in patients with nonrheumatic atrial fibrillation and recent transient ischaemic attack or minor ischaemic stroke. Lancet 1993; 342: 1255-62.
19. Samsa G, Matchar DB, Goldstein LB, et al. Quality of anticoagulation management among patients with atrial fibrillation: Results of a review of medical records from 2 communities. Arch Intern Med 2000; 160: 967-73.
20. Yousef ZR, Tandy SC, Tudor V, et al. Warfarin for non-rheumatic atrial fibrillation: Five year experience in a district general hospital. Heart 2004; 90: 1259-62.
21. Stafford RS, Singer DE. National patterns of warfarin use in atrial fibrillation. Arch Intern Med 1996; 156: 2537-41.
22. Bo S, Ciccone G, Scaglione L et al. Warfarin for non-valvar atrial fibrillation: Still underused in the 21st century? Heart 2003; 89: 553-54.
23. Lew SJ, Lim JK. Stroke prevention in elderly patients with atrial fibrillation. Singapore Med J 2002; 43: 198-1.
24. Llop R, Ferrer A, Agusti A, Vidal X, Arnau JM, Laporte JR. From clinical trials to clinical practice: Oral anticoagulation among patients with non-rheumatic, atrial fibrillation. Eur J Clin Pharmacol 1997; 53: 1-5.
25. Ibrahim SA, Kwoh CK. Underutilization of oral anticoagulant therapy for stroke prevention in elderly patients with heart failure. Am Heart J 2000; 140: 219-20.
26. Whittle J, Wickenheiser L, Venditti IN. Is warfarin underused in the treatment of elderly persons with atrial fibrillation? Arch Intern Med 1997; 157: 441-45.
27. Majeed A, Moser K, Carroll K. Trends in the prevalence and management of atrial fibrillation in general practice in England and Wales, 1994-1998: analysis of data from the general practice research database. Heart 2001; 86: 284-88.
28. Brass LM, Krumholz HM, Scinto JM, Radford M. Warfarin use among patients with atrial fibrillation. Stroke 1997; 28: 2382-89.
29. Ang SY, Peterson GM, Friesen WT, Vial JH. Review of antithrombotic drug usage in atrial fibrillation. J Clin Pharm Ther 1998; 23: 97-6.
30. Lip GY, Golding DJ, Nazir M, Beevers DG, Child DL, Fletcher RI. A survey of atrial fibrillation in general practice: The West Birmingham Atrial Fibrillation Project. Br J Gen Pract 1997; 47: 285-89.
31. Wheeldon NM, Tayler DI, Anagnostou E, Cook D, Wales C, Oakley GD. Screening for atrial fibrillation in primary care. Heart 1998; 79: 50-5.
32. Bhattacharyya A, Sharma SC. Atrial fibrillation in a general hospital: how well are we doing? Int J Clin Pract 1999; 53: 273-76.
33. Wensley S, Keir S, Caine S, MacMahon M. Additional risk factors in atrial fibrillation patients not receiving warfarin. Age Ageing 1999; 28: 355-57.
34. Adhiyaman V, Kamalakannan D, Oke A, Shah IU, White AD. Underutilization of antithrombotic therapy in atrial fibrillation. J R Soc Med 2000; 93: 138-40.
35. Howard PA, Ellerbeck EF, Engelman KK, Dunn MI. Warfarin for stroke prevention in octogenarians with atrial fibrillation. Am J Geriatr Cardiol 2001; 10: 139-44.
36. Mant JW, Richards SH, Hobbs FD, et al. Protocol for Birmingham atrial fibrillation treatment of the aged study (BAFTA): A randomised controlled trial of warfarin versus aspirin for stroke prevention in the management of atrial fibrillation in an elderly primary care population. BMC Cardiovasc Disord 2003; 3: 9.