New Clinical Performance Measures for Atrial Fibrillation

摘要

Based on five randomized trials, the strongest risk factor is history of stroke or transient ischemic attack (TIA; relative risk [RR] = 2.5), followed by diabetes (RR = 1.7), hypertension (RR = 1.6), coronary artery disease (RR = 1.5), heart failure or impaired left ventricular systolic function (RR = 1.4), and advancing age (RR = 1.4 per decade). Current guidelines recommend aspirin (81 to 325 mg daily) for patients with atrial fibrillation with no risk factors for stroke; aspirin in the same dosage or warfarin (Coumadin) to a target International Normalized Ratio (INR) of 2.5 for patients with one moderate risk factor; and warfarin to a target INR of 2.5 for patients with any high risk factor or more than one moderate risk factor.