Anti-thrombotic therapy for non-rheumatic atrial fibrillation

Recent randomized trials of antithrombotic therapy in non-rheumatic atrialfibrillation have helped to clarify the benefits of warfarin and aspirin.Low-risk patients (normotensives aged <60 with normal leftventricular function) have a small risk of thromboembolic events and areunlikely to benefit significantly from anticoagulants, but may benefit fromaspirin with little increase in risk of bleeding. High-risk patients(>75 years, impaired left ventricular function, previousthromboembolism and/or associated conditions such as hypertension anddiabetes mellitus) have an increased risk of thromboembolism, and benefitfrom long-term anticoagulant therapy to a greater degree than with aspirin,although at a risk of increased bleeding complications.