Letters Bad medicine: atrial fibrillation

Anticoagulant treatment is effective in atrial fibrillation

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f5429 (Published 12 September 2013) Cite this as: BMJ 2013;347:f5429
  1. John P Robson, general practitioner1,
  2. Gregory Y H Lip, professor of cardiovascular medicine2
  1. 1Centre for Primary Care and Public Health, Queen Mary University of London, London E1 2AB, UK
  2. 2University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham B18 7QH, UK
  1. j.robson{at}qmul.ac.uk

Spence’s concerns about bleeding and lack of efficacy in stroke prevention are well made for aspirin.1 The continued prescription of aspirin for 40% of people with atrial fibrillation lacks evidence of benefit in most cases and may be harmful, especially in elderly people.2

However, Spence is seriously misinformed about anticoagulant treatment in atrial fibrillation. Such treatment is highly effective, reducing strokes by 64% and all cause mortality by …

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