Turner White CommunicationsAbout TWCSubscribeContact TWCHomeSearch
Hospital PhysicianJCOMSMPBRMsCart
Current Contents
Past Issue Archives
Interactive:
Self-Assessment Questions
Review of
Clinical Signs
Clinical Review
Quiz
Pediatric Rounds
Resident Grand Rounds
Article Archives
Case Reports
Clinical Practice
Exams
Pediatric Rounds
Resident Grand Rounds
Review of
Clinical Signs

Guide to Reading
Hospital Physician
Editorial Board
Information for Authors

Reprints, Permissions, & Copyright
Site Map
Self-Assessment Questions

Neurology


Answer 4
  1. A 63-year-old man with no evidence of CAD. Patients with atrial fibrillation are divided into 3 risk groups based on their risk factors.4 High-risk factors include: poor left ventricular systolic function, age greater than 75 years, rheumatic mitral valve disease, prosthetic heart valve, prior stroke/TIA or systemic embolism, or hypertension. Patients with high-risk factors require warfarin treatment (if there is a contraindication or refusal to use warfarin, aspirin should be used). Low-risk group characteristics include age less than 65 years and absence of evidence of CAD (clinical or echocardiographic); these patients can be safely treated with aspirin. Moderate-risk factors include diabetes mellitus, CAD with preserved left ventricular systolic function, and age 65 to 75 years. Moderate-risk patients can be treated with warfarin or aspirin if only 1 of the indicated risk factors is present. Patients with more than 1 risk factor should be considered high risk and be treated with warfarin.

    REFERENCE
    4. Albers GW, Dalen JE, Laupacis A, et al. Antithrombotic therapy in atrial fibrillation. Chest 2001;199(1 Suppl):194S–206S.

Click here to return to the questions

 

Hospital Physician     JCOM     Seminars in Medical Practice
Hospital Physician Board Review Manuals
About TWC    Subscribe    Contact TWC    Home    Search   Site Map

Copyright © 2009, Turner White Communications
Updated 1/04/08 • kkj