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Warfarin treatment and risk of stroke among primary care patients with atrial fibrillation
Dalarna University, School of Education, Health and Social Studies, Medical Science. Uppsala universitet.ORCID iD: 0000-0002-6933-4637
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2016 (English)In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 50, no 5-6, 311-316 p.Article in journal (Refereed) Epub ahead of print
Abstract [en]

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.

Place, publisher, year, edition, pages
2016. Vol. 50, no 5-6, 311-316 p.
National Category
Clinical Medicine
Research subject
Health and Welfare
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URN: urn:nbn:se:du-22659DOI: 10.1080/14017431.2016.1215519ISI: 000390105700010PubMedID: 27460750OAI: oai:DiVA.org:du-22659DiVA: diva2:950888
Available from: 2016-08-03 Created: 2016-08-03 Last updated: 2017-01-23Bibliographically approved

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