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Warfarin Use and Ou...
Warfarin Use and Outcomes in Patients with Atrial Fibrillation Complicating Acute Coronary Syndromes
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Lopes, Renato D. (author)
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Starr, Aijing (author)
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Pieper, Carl F. (author)
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Al-Khatib, Sana M. (author)
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Newby, L. Kristin (author)
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Mehta, Rajendra H. (author)
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Van de Werf, Frans (author)
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Mahaffey, Kenneth W. (author)
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Armstrong, Paul W. (author)
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Harrington, Robert A. (author)
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White, Harvey D. (author)
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- Wallentin, Lars (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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Granger, Christopher B. (author)
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(creator_code:org_t)
- Elsevier BV, 2010
- 2010
- English.
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In: American Journal of Medicine. - : Elsevier BV. - 0002-9343 .- 1555-7162. ; 123:2, s. 134-140
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- BACKGROUND: We examined warfarin use at discharge (according to Congestive heart failure, Hypertension, Age > 75 years, Diabetes, Prior Stroke/transient ischemic attack score and bleeding risk) and its association with 6-month death or myocardial infarction in patients with post-acute coronary syndrome atrial fibrillation. METHODS: Of the 23,208 patients enrolled in the Platelet IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy, Platelet IIb/IIIa Antagonist for the Reduction of Acute Coronary Syndrome Events in a Global Organization Network A, and Superior Yield of the New Strategy of Enoxaparin, Revascularization and Glycoprotein IIb/IIIa Inhibitors trials, 4.0% (917 patients) had atrial fibrillation as an in-hospital complication and were discharged alive. Cox proportional hazards models were performed to assess 6-month outcomes after discharge. RESULTS: Overall, 13.5% of patients with an acute coronary syndrome complicated by atrial fibrillation received warfarin at discharge. Warfarin use among patients with atrial fibrillation had no relation with estimated stroke risk; similar rates were observed across Congestive heart failure, Hypertension, Age > 75 years, Diabetes, Prior Stroke/transient ischemic attack (CHADS(2)) scores (0, 13%; 1, 14%: >= 2, 13%) and across different bleeding risk categories (low risk, 11.9%: intermediate risk, 13.3%; high risk, 11.1%). Among patients with in-hospital atrial fibrillation, warfarin use at discharge was independently associated with a lower risk of death or myocardial infarction within 6 months of discharge (hazard ratio 0.39; 95% confidence interval, 0.15-0.98). CONCLUSION: Warfarin is associated with better 6-month outcomes among patients with atrial fibrillation complicating an acute coronary syndrome, but its use is not related to CHADS(2) score or bleeding risk.
Keyword
- Acute coronary syndrome
- Antithrombotics
- Atrial fibrillation
- Bleeding risk
- MEDICINE
- MEDICIN
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Lopes, Renato D.
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Starr, Aijing
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Pieper, Carl F.
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Al-Khatib, Sana ...
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Newby, L. Kristi ...
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Mehta, Rajendra ...
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show more...
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Van de Werf, Fra ...
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Mahaffey, Kennet ...
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Armstrong, Paul ...
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Harrington, Robe ...
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White, Harvey D.
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Wallentin, Lars
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Granger, Christo ...
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American Journal ...
- By the university
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Uppsala University