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


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 treatment, compared to no persistent treatment, was associated with a stroke preventing effect with fully adjusted HRs of 0.25 (95%CI 0.18-0.36) in women, and 0.25 (95%CI 0.19-0.32) 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.

SUBMITTER: Wandell P 

PROVIDER: S-EPMC5152680 | biostudies-literature | 2016 Oct - Dec

REPOSITORIES: biostudies-literature

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

Wändell Per P   Carlsson Axel C AC   Holzmann Martin J MJ   Ärnlöv Johan J   Johansson Sven-Erik SE   Sundquist Jan J   Sundquist Kristina K  

Scandinavian cardiovascular journal : SCJ 20160818 5-6


<h4>Objective</h4>Our aim was to study the risk of a first ischaemic stroke (IS) in patients with atrial fibrillation (AF) treated in primary healthcare.<h4>Design</h4>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, w  ...[more]

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