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New Assessment Quantifies Risks and Benefits of Warfarin Treatment for Atrial Fibrillation
Date:8/31/2009

OAKLAND, Calif., Aug. 31 /PRNewswire/ -- Warfarin (an oral anticoagulant) therapy for patients with atrial fibrillation - the most common type of significant heart rhythm disorder - appears to be most beneficial for the oldest patients, for those who have had a prior stroke and for patients with multiple risk factors for stroke, according to a new study by Kaiser Permanente and Massachusetts General Hospital researchers. This comparative effectiveness research study, among the first and largest to quantify warfarin's net clinical benefit - how much a treatment's potential benefits outweigh its risks - in the usual clinical care of patients with atrial fibrillation, appears in the September 1 issue of The Annals of Internal Medicine.

As part of the ongoing ATRIA (AnTicoagulation and Risk Factors In Atrial Fibrillation) study, researchers followed 13,559 adults with atrial fibrillation treated within Kaiser Permanente of Northern California from 1996 to 2003. To evaluate the risks and benefits of warfarin treatment and give patients and physicians quantitative guidance in making therapeutic decisions, the researchers analyzed rates of the two most significant adverse events associated with warfarin therapy - ischemic stroke, the type produced by arterial blockage, and intracranial hemorrhage, bleeding within and around the brain. In patients who did and did not take warfarin, the investigators balanced the reduction in ischemic stroke attributable to treatment against the increase in intracranial bleeding associated with warfarin. Since intracranial hemorrhages usually have worse outcomes than ischemic strokes, bleeding events were given greater weight in the comparison.

While warfarin therapy benefited most atrial fibrillation patients, the balance of benefits over risks was greatest in those at highest risk of stroke - those with multiple risk factors, those with a history of
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SOURCE Kaiser Permanente
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