RT Journal
A1 Singer DE, MD, Go AS, MD
T1 A new era in stroke prevention for atrial fibrillation: Comment on “current trial-associated outcomes with warfarin in prevention of stroke in patients with nonvalvular atrial fibrillation
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2012
FD April 23
VO 172
IS 8
SP 631
OP 633
DO 10.1001/archinternmed.2012.897
UL http://dx.doi.org/10.1001/archinternmed.2012.897
AB 
Atrial fibrillation, the most common significant cardiac arrhythmia, raises the risk of ischemic stroke 5-fold. Dose-adjusted warfarin therapy reduces this risk by two-thirds.2 However, warfarin therapy is burdensome and risky, and its effect varies as a result of food and drug interactions and genetic differences.3 The safe management of warfarin therapy demands frequent international normalized ratio (INR) testing and dose adjustment as well as ongoing patient education regarding common hazards. The risks of ischemic stroke and intracranial hemorrhage are minimized at INR values of 1.8 to 3.5.4 Beyond this range, the risks increase steeply.