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

Carlsson, Axel C. (author): Karolinska Institutet,Uppsala universitet,Kardiovaskulär epidemiologi,Karolinska Inst, Div Family Med, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden

Ärnlöv, Johan, 1970- (author): Högskolan Dalarna,Medicinsk vetenskap,Uppsala universitet,Kardiovaskulär epidemiologi,Dalarna Univ, Sch Hlth & Social Studies, Falun, Sweden.

Johansson, Sven Erik (author): Lund University,Lunds universitet,Allmänmedicin och klinisk epidemiologi,Forskargrupper vid Lunds universitet,Family Medicine and Clinical Epidemiology,Lund University Research Groups

Sundquist, Jan (author): Lund University,Lunds universitet,Allmänmedicin och klinisk epidemiologi,Forskargrupper vid Lunds universitet,Family Medicine and Clinical Epidemiology,Lund University Research Groups

Sundquist, Kristina (author): Lund University,Lunds universitet,Allmänmedicin, kardiovaskulär epidemiologi och levnadsvanor,Forskargrupper vid Lunds universitet,Family Medicine, Cardiovascular Epidemiology and Lifestyle,Lund University Research Groups

(creator_code:org_t)

2016-08-18
2016
English.
In: Scandinavian Cardiovascular Journal. - : Informa UK Limited. - 1401-7431 .- 1651-2006. ; 50:5-6, s. 311-316

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Abstract Subject headings

Objective Our aim was to study the risk of a first ischemic stroke in patients with atrial fibrillation (AF) treated in primary health care. 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. Ischemic stroke 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 34.7% of women and 40.9% 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 health care.

By the author/editor: Wändell, Per; Carlsson, Axel C ...; Holzmann, Martin ...; Ärnlöv, Johan, 1 ...; Johansson, Sven ...; Sundquist, Jan; show more...; Sundquist, Krist ...; show less...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Neurology

By the university: Högskolan Dalarna; Uppsala University; Lund University; Karolinska Institutet

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