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Association between antithrombotic treatment and hemorrhagic stroke in patients with atrial fibrillation: a cohort study in primary care
Dalarna University, School of Education, Health and Social Studies, Medical Science. Uppsala universitet.ORCID iD: 0000-0002-6933-4637
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2017 (English)In: European Journal of Clinical Pharmacology, ISSN 0031-6970, E-ISSN 1432-1041, Vol. 73, no 2, 215-221 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The objective of this study was to study the association between antithrombotic treatment and risk of hemorrhagic stroke (HS) in patients with atrial fibrillation (AF) treated in primary health care.

METHODS: Study population included all adults (n = 12,215) 45 years and older diagnosed with AF at 75 primary care centers in Sweden 2001-2007. Outcome was defined as a first hospital episode with a discharge episode of HS after the AF diagnosis. Association between HS and persistent treatment with antithrombotic agents (warfarin, acetylsalicylic acid (ASA), clopidogrel) was explored using Cox regression analysis, with hazard ratios (HRs) and 95 % CIs. Adjustment was made for age, socioeconomic status, and co-morbid cardiovascular conditions.

RESULTS: During a mean of 5.8 years (SD 2.4) of follow-up, 162 patients (1.3 %; 67 women and 95 men) with HS were recorded. The adjusted risk associated with persistent warfarin treatment compared to no antithrombotic treatment consistently showed no increased HS risk, HR for women 0.53 (95 % CI 0.23-1.27) and for men 0.55 (95 % CI 0.29-1.04); corresponding HRs for ASA were, for women, 0.45 (95 % CI 0.14-1.44) and, for men, 0.56 (95 % CI 0.24-1.29).

CONCLUSIONS: In this clinical setting, we found no evidence pointing to an increased risk of HS with antithrombotic treatment.

Place, publisher, year, edition, pages
2017. Vol. 73, no 2, 215-221 p.
Keyword [en]
Anticoagulants; Atrial fibrillation; Cardiovascular co-morbidity; Gender; Hemorrhagic stroke; Mortality
National Category
Clinical Medicine
Research subject
Health and Welfare
Identifiers
URN: urn:nbn:se:du-23336DOI: 10.1007/s00228-016-2152-8ISI: 000392308200010PubMedID: 27826643OAI: oai:DiVA.org:du-23336DiVA: diva2:1045889
Available from: 2016-11-11 Created: 2016-11-11 Last updated: 2017-03-09Bibliographically approved

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CiteExportLink to record
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Citation style
  • apa
  • harvard1
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