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Warfarin treatment and risk of stroke among primary care patients with atrial fibrillation

Wändell, Per LU ; Carlsson, Axel C. ; Holzmann, Martin J. ; Ärnlöv, Johan ; Johansson, Sven Erik LU ; Sundquist, Jan LU and Sundquist, Kristina LU (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
; ; ; ; ; and
organization
publishing date
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
2025-10-19 20:17:04
@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}},
}