title: Warfarin compared with aspirin for older Chinese patients with stable coronary heart diseases and atrial fibrillation complications.
abstract: OBJECTIVE
  To compare the therapeutic warfarin and aspirin efficacies for treatments of atrial fibrillation (AF) complicated with stable coronary heart disease particularly in older Chinese patients.
  
  
  METHODS
  In our prospective study 101 patients with AF and stable coronary heart disease older than 80 years were randomized into two groups. One group (n = 51) basically received 1.25 mg/day warfarin per os, followed by addition of 0.5 - 1.0 mg/day from day 3 - 5 if the international normalized ratio (INR) was initially < 1.5 and in order to achieve a maintained INR between 1.6 and 2.5 (warfarin group). The second group (n = 50) received 100 mg aspirin per day (control group). All patients were medicated and monitored for a period of 2 years. The primary endpoint was the occurrence of ischemic stroke or systemic embolism, and the composite secondary endpoint was non-fatal myocardial infarction and all causes of death. For safety evaluation, the hemorrhage rates were recorded.
  
  
  RESULTS
  The warfarin medication was superior regarding the overall occurrence of ischemic stroke or systemic embolism as well as non-fatal myocardial infarction and all causes of death outcomes compared to aspirin administration during the 2 years of medication (17.6% vs. 36.0%, p = 0.03), while there was no significant difference of mild (5 vs. 4), severe (2 vs. 1), and fatal (1 vs. 1) hemorrhage incidences between the warfarin and aspirin groups (p > 0.05).
  
  
  CONCLUSIONS
  Warfarin was found to be more efficacious than aspirin for an anticoagulation therapy of older Chinese patients with AF and stable coronary heart disease.
authors.forename: Xinbing
authors.initials: X
authors.lastname: Liu
authors.forename: Hongman
authors.initials: H
authors.lastname: Huang
authors.forename: Jianhua
authors.initials: J
authors.lastname: Yu
authors.forename: Guoliang
authors.initials: G
authors.lastname: Cao
authors.forename: Liuliu
authors.initials: L
authors.lastname: Feng
authors.forename: Qitan
authors.initials: Q
authors.lastname: Xu
authors.forename: Shufu
authors.initials: S
authors.lastname: Zhang
authors.forename: Mingcheng
authors.initials: M
authors.lastname: Zhou
authors.forename: Yigang
authors.initials: Y
authors.lastname: Li
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D001241:Aspirin / Q000009:adverse effects / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D001777:Blood Coagulation / Q000187:drug effects*; D002681:China; D003327:Coronary Disease / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D011446:Prospective Studies; D020521:Stroke / Q000097:blood / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D013997:Time Factors; D016896:Treatment Outcome; D014859:Warfarin / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D014859:Warfarin; D001241:Aspirin