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What Are the Major Recommendations for Primary Prevention with Anticoagulants in Atrial Fibrillation?

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What Are the Major Recommendations for Primary Prevention with Anticoagulants in Atrial Fibrillation?

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The effectiveness of anticoagulants in the prevention trials suggests that treatment with warfarin should probably be used for most patients who have atrial fibrillation and either a TIA or stroke, because they have a high risk of recurrent vascular events (15-20% per year). Those patients with adverse prognostic factors such as hypertension and recent congestive heart failure are especially vulnerable to recurrent stroke and may benefit most from oral anticoagulants. The dosage of warfarin that maximizes efficacy and safety should be between INR 2.0 and 4.0. Because lower-intensity therapy is associated with a lower incidence of major and minor bleeding complications, reduces the risk by a factor of four. A low-dosage warfarin regimen, which refers to an INR below 2.0, is ineffective. Aspirin is an alternative for patients with AF and a low risk of ischemic stroke (young patients and ‘lone’ AF) and for patients for whom warfarin is contraindicated. The dosage of aspirin should probabl

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