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- W4248417814 abstract "Letters1 March 1998Intensity of Anticoagulation To Prevent Stroke in Patients with Atrial FibrillationJohn V.L. Sheffield, MD and Eric B. Larson, MD, MPHJohn V.L. Sheffield, MDUniversity of Washington; Seattle, WA 98195Search for more papers by this author and Eric B. Larson, MD, MPHUniversity of Washington; Seattle, WA 98195Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-5-199803010-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree that INRs of 2.0 or greater seem to provide optimal protection against embolic stroke and that the case–control study by Hylek and colleagues [1] demonstrates some protection against embolic stroke in the INR range of 1.6 to 2.0 Although it may be reasonable to target an INR of 2.0 within a range of 1.6 to 2.5 for some patients, we believe that several points must be considered before a less effective level of anticoagulation is accepted for elderly patients, who are also at highest risk for embolic stroke.According to the results of a physician survey, ...References1. Hylek EM, Skates SJ, Sheehan MA, Singer DE. An analysis of the lowest effective intensity of prophylactic anticoagulation for patients with nonrheumatic atrial fibrillation, N Engl J Med. 1996; 335:540-6. Google Scholar2. McCrory DC, Matchar DB, Samsa G, Sanders LL, Pritchett EL. Physician attitudes about anticoagulation for nonvalvular atrial fibrillation in the elderly. Arch Intern Med. 1995; 155:277-81. Google Scholar3. Adjusted-dose warfarin versus low-intensity, fixed-dose warfarin plus aspirin for high-risk patients with atrial fibrillation: stroke prevention in atrial fibrillation III randomized clinical trial. Stroke Prevention in Atrial Fibrillation Investigators. Lancet. 1996; 348:633-8. Google Scholar4. Optimal oral anticoagulant therapy in patients with nonrheumatic atrial fibrillation and recent cerebral ischemia. The European Atrial Fibrillation Trial Study Group. N Engl J Med. 1995; 333:5-10. Google Scholar Author, Article, and Disclosure InformationAuthors: John V.L. Sheffield, MD; Eric B. Larson, MD, MPHAffiliations: University of Washington; Seattle, WA 98195 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAntithrombotic Therapy in Atrial FibrillationAntithrombotic Therapy in Atrial Fibrillation 1 March 1998Volume 128, Issue 5Page: 408KeywordsAtrial fibrillationElderlyHemorrhageHemorrhagic strokeInternational normalized ratioStroke ePublished: 15 August 2000 Issue Published: 1 March 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ..." @default.
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- W4248417814 title "Intensity of Anticoagulation To Prevent Stroke in Patients with Atrial Fibrillation" @default.
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