Abstract | BACKGROUND AND PURPOSE: METHODS: We followed 13,559 patients with atrial fibrillation enrolled in an integrated healthcare delivery system for a median 6 years. Incident ischemic strokes and ICHs were identified from computerized databases and validated through medical record review. The association of warfarin and international normalized ratio at presentation with 30-day mortality was modeled using multivariable logistic regression adjusting for clinical factors. RESULTS: We identified 1025 incident ischemic strokes and 299 ICHs during follow-up. Compared with no antithrombotic therapy, warfarin was associated with reduced Rankin score and lower 30-day mortality from ischemic stroke (adjusted OR, 0.64; 95% CI, 0.45-0.91) but a higher mortality from ICH (OR, 1.62; 95% CI, 0.88-2.98). Therapeutic international normalized ratios (2-3) were associated with an especially low ischemic stroke mortality (OR, 0.38; 95% CI, 0.20-0.70), whereas international normalized ratios>3 increased the odds of dying of ICH by 2.66-fold (95% CI, 1.21-5.86). CONCLUSIONS:
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Authors | Margaret C Fang, Alan S Go, Yuchiao Chang, Leila H Borowsky, Niela K Pomernacki, Natalia Udaltsova, Daniel E Singer |
Journal | Stroke
(Stroke)
Vol. 43
Issue 7
Pg. 1795-9
(Jul 2012)
ISSN: 1524-4628 [Electronic] United States |
PMID | 22539546
(Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Aged
- Aged, 80 and over
- Anticoagulants
(therapeutic use)
- Atrial Fibrillation
(drug therapy, mortality)
- Brain Ischemia
(drug therapy, mortality)
- Cohort Studies
- Female
- Follow-Up Studies
- Humans
- Intracranial Hemorrhages
(drug therapy, mortality)
- Male
- Middle Aged
- Risk Factors
- Stroke
(drug therapy, mortality)
- Survival Rate
(trends)
- Time Factors
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