Recommendations in Canada changed in 2014, advancing the age at which patients with atrial fibrillation should start anticoagulation in the absence of other risk factors from 75 to 65.
Current guidelines do not recommend treatment for patients at low risk of stroke who are younger than 65.
In addition, Coumadin was replaced by new anticoagulant drugs that pose a lower risk of bleeding. These anticoagulant drugs are approved by health authorities such as Health Canada and the U.S. Food and Drug Administration (FDA) to reduce the risk of stroke in patients with atrial fibrillation. It is now possible to benefit from the anticoagulant effects by minimizing the risk of bleeding in a younger population.
With the BRAIN-AF study, we hypothesize that by starting low-dose anticoagulation therapy in patients with atrial fibrillation at low risk of stroke, we can reduce the risk of cognitive decline, stroke, and transient ischemic attack.