Trial: Warfarin vs aspirin for stroke prevention in octogenarians with atrial fibrillation (WASPO)
Authors: Rash A; Downes T; Portner R; Yeo WW; Morgan N; Channer KS.
Reference: Age Ageing. 2007; 36(2): 151-6.
Purpose: Primary thromboprophyaxis for atrial fibrillation.
Number of Patients: 75
Number of Centers: 1
Design: Patients >80 and <90 years old were randomized to receive either dose-adjusted warfarin (INR 2.0-3.0) or aspirin 300 mg daily. Follow-up for 1 year with 3 monthly visits.
Authors Conclusion: Dose-adjusted warfarin was significantly better tolerated with fewer adverse events than aspirin 300 mg daily in this elderly population.
Key words: Atrial fibrillation
Comment: Aspirin 300 mg daily caused more bleeding-related adverse events than warfarin in ambulatory octogenarians with permanent atrial fibrillation. The authors noted that while a lower dose of aspirin (75 mg daily) may be better tolerated by elderly patients, this lower dose has not demonstrated efficacy in atrial fibrillation. This study was conducted in ambulatory patients with Folstein mini mental score >25; results may not be applicable to octogenarians with impaired ambulation or mental status.
Ongoing Related Studies:
1. Efficacy and Safety of Rivaroxaban for the Prevention of Stroke and Embolism in Subjects with Non-valvular Atrial Fibrillation
2. A Study Compaing Once Daily Oral Rivaroxaban With Adjusted-Dose Oral Warfarin for the Prevention of Stroke in Subjects With Non-Valvular Atrial Fibrillation
3. Apizaban for the Prevention of Stroke in Subjects With Atrial Fibrillation
4. Direct Factor Xa Inhibitor YM150 for Prevention of Stroke in Subjects With Non-Valvular Atrial Fibrillation
5. Randomized Evaluation of Long Term Anticoagulant Therapy (RE-LY) With Dabigatran Etexilate
6. Warfarin Versus Aspirin in Reduced Cardiac Ejection Fraction (WARCEF) Trial
7. A Phase III Study of Apixaban in Patients with Atrial Fibrillation
8. S.I.F.A. II: Prevention of Thromboembolic Events in Patients with Nonrheumatic Atrial Fibrillation
9. A Study to Assess the Safety of a Potential New Drug in Comparison to the Standard Practice of Dosing with Warfarin for Non-valvular Atrial Fibrillation
Summary written by Heather M. Ross, MS, APRN, NP
