Here's a brief summary of the MRC TPT trial which looked at the primary
prevention of IHD in high risk men.
Warfarin & aspirin together reduced heart disease by 35%. Slight increase
in risk of intra-cranial bleeding.
Warfarin by itself reduced risk of heart disease by 20%.
Aspirin by itself reduced risk of heart disease by 20%.
The INR target was 1.5.
Depending on how you classify 'high risk', and if you assume that women
will also benefit, some 9- 17% of the population might benefit from
assessment and treatment!!
More detailed results awaited. The workload implications are enormous, but
also so are the potential benefits. I think the word 'prevention' should be
changed to 'postponed' by x years.
Sounds much cheaper than statin treatment, but INR adjustment is
time-consuming.
John Apps
"Better to live one day as a tiger, than a thousand years as a sheep"
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