Comparison of antithrombotic efficacy and safety of different doses of warfarin and aspirin in elderly patients with persistent atrial fibrillation

Objectives To observe the efficacy and safety of different doses of warfarin and aspirin in elderly patients with persistent atrial fibrillation.Methods A total of 217 elderly patients aged≥75 with persistent atrial fibrillation were divided into 4 groups: 54 cases received high-intensity anticoagulation with warfarin [2.0 international normalized ratio(INR) ≤3.0],53 cases received low-intensity anticoagulation with warfarin(1.6≤INR≤2.0),47 cases received aspirin 325 mg/d,and 63 cases received aspirin 200 mg/d.The incidence rates of bleeding and thromboembolism events in these groups were observed.Results The incidence rates of thromboembolism events in high-and low-intensity anticoagulation with warfarin groups were significantly lower than those in patients received aspirin 325 mg/d(χ2=6.487,P=0.011;χ2=7.929,P=0.005;χ2=6.354,P=0.012;χ2=7.771,P=0.005).The incidence rate of bleeding events in patients received high-intensity anticoagulation with warfarin was significantly higher than those in patients received low-intensity anticoagulation with warfarin and aspirin 200 mg/d(14.8% vs.0 vs.0,P0.05).There was no significant difference in incidence rate of bleeding events between patients received high-intensity anticoagulation with warfarin and patients received aspirin 325 mg/d(P0.05).Conclusions The treatment of low-intensity anticoagulation with warfarin(1.6≤INR≤2.0) is possibly safe and effective in patients aged≥75 with persistent atrial fibrillation,which may be better than aspirin therapy.