We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editor's Correspondence |

Warfarin vs Aspirin and AFASAK 2

Jeffrey M. Bloom, MD
Arch Intern Med. 1999;159(9):1010. doi:.
Text Size: A A A
Published online


In a recent issue of the Archives, one notes how the article on the Second Copenhagen Atrial Fibrillation, Aspirin, and Anticoagulation Study (AFASAK 2) by Gulløv et al1 and Albers'2 editorial conceal the most striking data from AFASAK 2, namely, that warfarin was not statistically significantly superior to aspirin alone for stroke prevention in atrial fibrillation. The cumulative primary event rates were 3.6% with aspirin and 2.8% with adjusted-dose warfarin sodium (P=.67). The introductory dependent clause in the "Conclusions" section of the Gulløv et al abstract— "Although the difference was insignificant . . ." —perhaps should be gist of the final conclusion vis-à-vis AFASAK 2's aspirin vs warfarin. The abstract's "Conclusions" section, however, cloaks the data regarding warfarin vs aspirin alone. No mention at all is made of the above findings. Albers' editorial likewise footnotes his position with no mention, for example, of another important recent meta-analysis about stroke, anticoagulation, and atrial fibrillation3 in which the margin between the benefit and harm for warfarin prophylaxis in patients with chronic nonvalvular atrial fibrillation was shown to be uncomfortably thin.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles