What are the benefits of anticoagulation in patients with nonvalvular AF?
Anticoagulation can provide protection against ischemic stroke and other cardioembolic events in nonvalvular AF patients. Certain factors such as age greater than 75 years can favor rather than oppose anticoagulation. Treatment of hypertension in AF patients reduces the risk of both ICH and ischemic stroke and hence has dual benefits for anticoagulated patients. Additionally, adjusted-dose warfarin (target INR, 2 to 3) appears to offer protection against MI comparable to that provided by aspirin in AF patients. Furthermore, in a trial of 707 subjects randomized 2:1 to percutaneous LAA closure with the WATCHMAN device versus adjusted-dose warfarin (target INR, 2 to 3), LAA closure was noninferior to warfarin for preventing the primary outcome of ischemic or hemorrhagic stroke, cardiac or unexplained death, or systemic embolism during the follow-up period. 