Warfarin in elderly -- Birmingham study

Mant J et al. for BAFTA investigators. Warfarin v. aspirin in an elderly community population with atrial fibrillation (the Birmingham Atrial Fibrillation Treatment of the Aged Study, BAFTA): a randomized clinical trial

patients: 973 patients 75+ age, mean 81, SD 4 from primary care were randomized to aspirin 75 mg or warfarin with INR target of 2-3, and followed a mean 2.7 years. The endpoint was fatal or disabling stroke, ICH, an arterial embolism.

results: in warfarin group there were 24 events, with 2 ICH and remainder ischemic strokes, in aspirin group there were 48 events. Yearly risk reduction was 3.8 percent in aspirin group, 1.8 percent in warfarin group, risk reduction 2 %, p=0.003. Risk of hemorrhagic events increased 0.2 % in warfarin group, 1.4 to 1.6 percent.

Warfarin is treatment of choice.