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Dual antiplatelet therapy is not optimal for stroke prevention in patients with atrial fibrillation
Article first published online: 7 JAN 2010
DOI: 10.1111/j.1747-4949.2009.00397.x
© 2010 The Author. Journal compilation © 2010 World Stroke Organization
Additional Information
How to Cite
Chamorro, Á. (2010), Dual antiplatelet therapy is not optimal for stroke prevention in patients with atrial fibrillation. International Journal of Stroke, 5: 28–29. doi: 10.1111/j.1747-4949.2009.00397.x
Publication History
- Issue published online: 7 JAN 2010
- Article first published online: 7 JAN 2010
- Abstract
- Article
- References
- Cited By
Keywords:
- atrial fibrillation;
- aspirin;
- clopidogrel;
- oral anticoagulation
The superior efficacy of oral anticoagulation over aspirin for prevention of recurrent stroke in patients with atrial fibrillation is widely acknowledged. However, oral anticoagulation therapy is notorious for having a narrow therapeutic index, numerous drug and dietary interactions, and a significant risk of serious bleeding. The value of dual antiplatelet therapy for stroke prevention in patients with atrial fibrillation has been assessed in the ACTIVE A trial. In this study, the relative risk of primary events was significantly decreased in patients allocated clopidogrel and aspirin compared with patients receiving aspirin alone. However, the relative risk of major bleeding was also significantly increased. This article analyses critically the role of dual antiplatelet therapy for stroke prevention in patients with atrial fibrillation.