Long term anticoagulation is no better than antiplatelet treatment in non-rheumatic atrial fibrillation

Oral anticoagulation is widely used in preference to antiplatelet treatment in patients with non-rheumatic atrial fibrillation to reduce the risk of cardiovascular mortality and morbidity. The evidence for this is based on results of randomised controlled trials comparing long term anticoagulation versus placebo and antiplatelet treatment versus placebo. On p 321 Taylor et al present a systematic review of direct comparisons of long term anticoagulation and antiplatelet treatment. They found no significant differences between the two treatments in the prevention of fatal stroke and fatal and non-fatal cardiovascular events. There was a difference of borderline significance for non-fatal stroke. Further large scale randomised controlled trials are needed to establish the value of long term anticoagulation in patients with non-rheumatic atrial fibrillation.

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Relevant Article

Systematic review of long term anticoagulation or antiplatelet treatment in patients with non-rheumatic atrial fibrillation

F C Taylor, H Cohen, and S Ebrahim
BMJ 2001 322: 321-326. [Abstract] [Full Text] [PDF]