In AF for stroke in afya

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Primary prevention of stroke if have AF - use CHA2DS2-VASc and CHADS2
Aspirin - half as effective as Warfarin
Warfarin reduces stroke by 68% and death by 33% cf placebo

Secondary prevention of stroke in AF (non-rheumatic)
warfarin - prevents 90 vascular events (mostly stroke) in 1000 pts treated
Aspirin - prevents 40 out of 1000
(but give Aspirin for first 2/52 or until bleed is excluded)

Note - Anticoag still effective as age inc, antiplatelet gets less effective as age inc

Long term risk of stroke in AF - use CHADS2
(CCF, HT, Age>75, DM, prior stroke or TIA - 2)
score 0 - low risk - aspirin or nothing
score 1 - mod risk - aspirin or warfarin (pt preference)
score 2+ - high risk - Warfarin

To help choice with low or mod risk, use CHA2DS2-VASc
(CCF, HT, Age (>75 - 2, 65-75 - 1), DM, prior stroke/TIA (- 2), Vascular disease (MI, PAD, aortic plaque), Female)
If this is >2 use warfarin
If 1 use either
If 0 use nothing or aspirin if pt insists

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