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Association of Prec...
Association of Preceding Antithrombotic Therapy in Atrial Fibrillation Patients With Ischemic Stroke, Intracranial Hemorrhage, or Gastrointestinal Bleed and Mortality
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- Komen, Joris J. (författare)
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands; Department of Healthcare Development, Stockholm University, Stockholm, Sweden
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- Forslund, Tomas (författare)
- Karolinska Institutet
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- Mantel-Teeuwisse, Aukje K (författare)
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
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- Klungel, Olaf H. (författare)
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
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- von Euler, Mia, 1967- (författare)
- Karolinska Institutet
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- Braunschweig, Frieder (författare)
- Karolinska Institutet
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- Wallén, Håkan (författare)
- Karolinska Institutet
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- Hjemdahl, Paul (författare)
- Karolinska Institutet
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(creator_code:org_t)
- 2019-10-26
- 2021
- Engelska.
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Ingår i: European Heart Journal - Cardiovascular Pharmacotherapy. - Oxford : Oxford University Press. - 2055-6837 .- 2055-6845. ; 7:1, s. 3-10
- Relaterad länk:
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https://doi.org/10.1...
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https://academic.oup...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- AIMS: To analyze 90-day mortality in AF patients after a stroke or a severe bleed and assess associations with the type of antithrombotic treatment at the event.METHODS AND RESULTS: From the Stockholm Healthcare database, we selected 6 017 patients with a known history of AF who were diagnosed with ischemic stroke, 3 006 with intracranial hemorrhage, and 4 291 with a severe gastrointestinal bleed (GIB). The 90-day mortality rates were 25.1% after ischemic stroke, 31.6% after intracranial hemorrhage, and 16.2% after severe GIB. We used Cox regression and propensity score matched analyses to test the association between antithrombotic treatment at the event and 90-day mortality. After intracranial hemorrhage, there was a significantly higher mortality rate in warfarin compared to NOAC treated patients (adjusted hazard ratio (aHR): 1.36 CI: 1.04 - 1.78). After an ischemic stroke and a severe GIB, patients receiving antiplatelets or no antithrombotic treatment had significantly higher mortality rates compared to patients on NOACs, but there was no difference comparing warfarin to NOACs (aHR 0.84 CI: 0.63 - 1.12 after ischemic stroke, aHR 0.91 CI: 0.66 - 1.25 after severe GIB). Propensity score matched analysis yielded similar results.CONCLUSION: Mortality rates were high in AF patients suffering from an ischemic stroke, an intracranial hemorrhage, or a severe GIB. NOAC treatment was associated with a lower 90 day mortality after intracranial hemorrhage than warfarin.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- NOAC
- antiplatelet agents
- bleeding
- mortality
- stroke
- warfarin
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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