Warfarin treatment and risk of stroke among primary care patients with atrial fibrillation
(2016) In Scandinavian Cardiovascular Journal 50(5-6). p.311-316- Abstract
Objective. Our aim was to study the risk of a first ischaemic stroke (IS) in patients with atrial fibrillation (AF) treated in primary healthcare. Design. The study population included all adults (n = 11,517), 45 years and older diagnosed with AF, from 75 primary care centres in Sweden between 2001 and 2007. IS was defined as a hospital care event of stroke between 2001 and 2010. Association between incident stroke and warfarin treatment was explored using Cox regression analysis, with hazard ratios (HRs), and 95% confidence intervals (95%CIs). Adjustment was made for age, socioeconomic factors and co-morbidity. Results. Persistent treatment with warfarin was present among 33.7% of women and 40.0% among men. Persistent warfarin... (More)
Objective. Our aim was to study the risk of a first ischaemic stroke (IS) in patients with atrial fibrillation (AF) treated in primary healthcare. Design. The study population included all adults (n = 11,517), 45 years and older diagnosed with AF, from 75 primary care centres in Sweden between 2001 and 2007. IS was defined as a hospital care event of stroke between 2001 and 2010. Association between incident stroke and warfarin treatment was explored using Cox regression analysis, with hazard ratios (HRs), and 95% confidence intervals (95%CIs). Adjustment was made for age, socioeconomic factors and co-morbidity. Results. Persistent treatment with warfarin was present among 33.7% of women and 40.0% among men. Persistent warfarin treatment, compared to no persistent treatment, was associated with a stroke preventing effect with fully adjusted HRs of 0.25 (95%CI 0. 0.26–0.45) in women, and 0.25 (95%CI 0.28–0.43) in men. A CHA2DS2-VASc score of at least two among women, and three among men, was associated with a stroke risk exceeding 18% during a mean follow-up of 5.4 years. Risk of haemorrhagic stroke was not increased. Conclusions. Warfarin is effective in preventing stroke in AF patients in primary healthcare.
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- author
- Wändell, Per LU ; Carlsson, Axel C. ; Holzmann, Martin J. ; Ärnlöv, Johan ; Johansson, Sven Erik LU ; Sundquist, Jan LU and Sundquist, Kristina LU
- organization
- publishing date
- 2016-08-18
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- anticoagulant, Atrial fibrillation, co-morbidity, follow-up, gender, ischaemic stroke
- in
- Scandinavian Cardiovascular Journal
- volume
- 50
- issue
- 5-6
- pages
- 6 pages
- publisher
- Taylor & Francis
- external identifiers
-
- scopus:84982279694
- pmid:27460750
- wos:000390105700010
- ISSN
- 1401-7431
- DOI
- 10.1080/14017431.2016.1215519
- language
- English
- LU publication?
- yes
- id
- 209cae9e-8063-41e0-bd6c-058c487b31aa
- date added to LUP
- 2016-09-05 16:36:37
- date last changed
- 2024-04-05 05:53:32
@article{209cae9e-8063-41e0-bd6c-058c487b31aa, abstract = {{<p>Objective. Our aim was to study the risk of a first ischaemic stroke (IS) in patients with atrial fibrillation (AF) treated in primary healthcare. Design. The study population included all adults (n = 11,517), 45 years and older diagnosed with AF, from 75 primary care centres in Sweden between 2001 and 2007. IS was defined as a hospital care event of stroke between 2001 and 2010. Association between incident stroke and warfarin treatment was explored using Cox regression analysis, with hazard ratios (HRs), and 95% confidence intervals (95%CIs). Adjustment was made for age, socioeconomic factors and co-morbidity. Results. Persistent treatment with warfarin was present among 33.7% of women and 40.0% among men. Persistent warfarin treatment, compared to no persistent treatment, was associated with a stroke preventing effect with fully adjusted HRs of 0.25 (95%CI 0. 0.26–0.45) in women, and 0.25 (95%CI 0.28–0.43) in men. A CHA<sub>2</sub>DS<sub>2</sub>-VASc score of at least two among women, and three among men, was associated with a stroke risk exceeding 18% during a mean follow-up of 5.4 years. Risk of haemorrhagic stroke was not increased. Conclusions. Warfarin is effective in preventing stroke in AF patients in primary healthcare.</p>}}, author = {{Wändell, Per and Carlsson, Axel C. and Holzmann, Martin J. and Ärnlöv, Johan and Johansson, Sven Erik and Sundquist, Jan and Sundquist, Kristina}}, issn = {{1401-7431}}, keywords = {{anticoagulant; Atrial fibrillation; co-morbidity; follow-up; gender; ischaemic stroke}}, language = {{eng}}, month = {{08}}, number = {{5-6}}, pages = {{311--316}}, publisher = {{Taylor & Francis}}, series = {{Scandinavian Cardiovascular Journal}}, title = {{Warfarin treatment and risk of stroke among primary care patients with atrial fibrillation}}, url = {{http://dx.doi.org/10.1080/14017431.2016.1215519}}, doi = {{10.1080/14017431.2016.1215519}}, volume = {{50}}, year = {{2016}}, }