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GP study finds warfarin more effective than aspirin at preventing stroke in over-75s

Warfarin is more effective than aspirin in preventing stroke in older patients with atrial fibrillation, according to a general practice study.

The study, of 973 patients over 75 from 260 practices, found 24 primary events (strokes, intracranial haemorrhages and systemic emboli) in those randomised to warfarin and 48 in those who were allocated aspirin treatment, a relative risk reduction of 48%.

The patients, mean age 81, were identified through computer searches and opportunistic pulse measurements, with confirmation by ECG, and were followed up for a mean 2.7 years.

The researchers reported that there was no increased risk of major haemorrhage in those on warfarin compared to those on aspirin, and said warfarin should be used much more widely in older people with AF.

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