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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
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
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
2017-01-29 04:32:06
@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},
  keyword      = {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},
  volume       = {50},
  year         = {2016},
}