Prevention of cerebral thromboembolism by low-dose anticoagulant therapy in atrial fibrillation with mitral regurgitation

Citation
Y. Wada et al., Prevention of cerebral thromboembolism by low-dose anticoagulant therapy in atrial fibrillation with mitral regurgitation, J CARDIO PH, 37(4), 2001, pp. 422-426
Citations number
26
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Journal title
JOURNAL OF CARDIOVASCULAR PHARMACOLOGY
ISSN journal
0160-2446 → ACNP
Volume
37
Issue
4
Year of publication
2001
Pages
422 - 426
Database
ISI
SICI code
0160-2446(200104)37:4<422:POCTBL>2.0.ZU;2-5
Abstract
Controversy exists regarding the influence of mitral regurgitation (MR) on thromboembolic risk in patients with atrial fibrillation. We aimed to inves tigate retrospectively a reduction of risk for stroke due to MR in atrial f ibrillation and to evaluate the effectiveness of low-intensity anticoagulat ion therapy. In 313 patients with atrial fibrillation, transthoracic echoca rdiography was performed and MR was graded. Between the groups with no or m ild MR (n = 209) and with moderate or severe MR (n = 104), age, sex, treatm ent, history of diabetes, hypertension, hyperlipemia and mitral stenosis, a nd previous stroke were compared. No significant differences in clinical ch aracteristics, treatment, or history were observed between the two groups. The incidence of thromboembolism was significantly higher in the group with no MR (48 patients [23%]) than in the group with MR (14 patients [13%], p < 0.05). In the MR group, previous stroke was frequently observed in patien ts without warfarin treatment (11 of 51 patients) compared with patients wi th low-dose warfarin treatment (international normalized ratio of 1.6-1.8) (3 of 53 patients, p < 0.05). Consequently, the thromboembolic event was ma rkedly prevented by low-dose warfarin treatment.