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(Stroke. 2006;37:274.)
© 2006 American Heart Association, Inc.

Cochrane Corner

Antiplatelet Therapy for Preventing Stroke in Patients With Nonvalvular Atrial Fibrillation and No Previous History of Stroke or Transient Ischemic Attacks

From the University of Texas Health Science Center at San Antonio.

Correspondence to Maria I. Aguilar, SPS3 Coordinating Center, 4647 Medical Dr, San Antonio, TX. E-mail aguilarm2@uthscsa.edu

Key Words: aspirin • antiplatelet therapy • atrial fibrillation • stroke

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Antiplatelet agents such as aspirin are modestly efficacious for preventing serious vascular events in patients with atrial fibrillation (AF) who are not treated with more efficacious oral anticoagulants.

	Background

 
Nonvalvular AF carries an increased risk of stroke. Antiplatelet therapy (APT) is proven effective for stroke prevention in most patients at high-risk for vascular events, but its value for primary stroke prevention in patients with nonvalvular AF merits separate consideration because of the suspected cardioembolic mechanism of most strokes in AF patients.

	Objectives

 
The goal of this review is to assess the efficacy and safety of long-term APT for primary prevention of stroke in patients with chronic nonvalvular AF.

	Search Strategy

 
We searched the Cochrane Stroke Group Trials Register (August 2004). In addition, we searched the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2005), MEDLINE (1966 to June 2004), and the reference lists of recent review articles. We also contacted experts working in the field to identify unpublished and ongoing trials.

	Data Collection and Analysis

 
Randomized trials comparing long-term APT with placebo or control in patients with nonvalvular AF and no history of transient ischemic attack (TIA) or stroke were independently selected and analyzed by 2 authors, extracting the data for each outcome. A sensitivity analysis included 1 additional randomized trial¹ involving primary prevention with aspirin plus very low-dose warfarin versus control. An additional randomized trial, the Japanese Atrial Fibrillation Stroke Trial, has been completed, but results have not been published.

	Main Results

 
Three trials tested aspirin in dosages ranging from 75 mg to 325 mg per . . . [Full Text of this Article]