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Atrial fibrillation (AF) is present in about 12% of patients older than 75, and it increases stroke risk fivefold. Although anticoagulants clearly are more effective than antiplatelet agents for lowering stroke risk, their relative risks and benefits in elders, who might be at higher risk for intracranial hemorrhage than are younger people, are not clear. Because of concerns about hemorrhage, fewer than half of older patients with AF receive warfarin.
In a prospective study, investigators compared the efficacy of warfarin with that of aspirin for preventing stroke in 973 patients (age, ≥75; mean age, 81.5) with AF who were recruited from 260 general practices in England and Wales. Patients were randomized to receive either warfarin (target i…