Question:

What is the evidence for an alternative anticoagulation e.g. dipyridamole in a patient with AF, who is allergic to aspirin and that warfarin is contra-indicated?

5 February 2008 note: This question is over 2 years old and may differ to any new research.

The CKS guideline on AF [1] updated in 2007, reports:

“The role of clopidogrel, dipyridamole, and ticlopidine is not certain at the present time and further studies are needed [Aguilar and Hart, 2005a].”

The above passage was based on a 2005 Cochrane Systematic Review.  Since the CKS guideline has been published the Cochrane review has been updated [2].  However, this does not appear to make any new, specific recommendations regarding alternatives to asprin. 

References

1) http://cks.library.nhs.uk/atrial_fibrillation/view_whole_guidance
2) http://www.cochrane.org/reviews/en/ab006186.html
 

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