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Preventing Stroke: The Choice Between Aspirin And Warfarin

y and I think this study identifies them with certainty."

In people with atrial fibrillation, blood clots can form in the upper chambers of the heart. These clots can break loose, be pumped into the bloodstream, and carried to the brain where they can cause a stroke. Atrial fibrillation primarily affects people over the age of 60 and is diagnosed by electrocardiogram. While some people have no symptoms, most experience a sensation of rapid heart beats or skipped beats.

The SPAF trials, which started in 1987, have involved about 4,000 patient volunteers with atrial fibrillation at 25 medical centers in the United States and Canada. Results from SPAF I, reported in 1990, found an 80 percent reduction in stroke risk for persons with atrial fibrillation who receive treatment with aspirin or warfarin. The SPAF II study, reported in 1994, identified the 60 percent of people with atrial fibrillation for whom a daily adult aspirin provides adequate protection against stroke with minimal complications. This group consists of those younger than 75 and those older than 75 with no additional stroke risk factors such as high blood pressure or heart disease. SPAF III studied the remaining 40 percent of atrial fibrillation patients who had additional risk factors for stroke.

The NINDS, one of the National Institutes of Health located in Bethesda, Maryland, is the nation's leading supporter of research on the brain and nervous system and is a lead agency for the Congressionally designated Decade of the Brain.

** Stroke Prevention in Atrial Fibrillation Investigators. "Prospective Identification of Patients with Nonvalvular Atrial Fibrillation at Low Risk of Stroke During Treatment with Aspirin: Stroke Prevention in Atrial Fibrillation III Study." JAMA, Vol. 279, No. 16, April 22/29, 1998, pp. 1273-1277.


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Contact: Margo Warren
301/ 496-5751
NIH/National Institute of Neurological Disorders and Stroke
21-Apr-1998


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