Key result
Asian AF patients on warfarin linked to ~306% higher ICH risk versus white patients.
Why the study?
Whether the greater risk of intracranial hemorrhage seen in nonwhites in the general population applies to patients with atrial fibrillation, and whether warfarin confers a comparable risk, is unknown.
Does race/ethnicity affect the risk of intracranial hemorrhage in patients with atrial fibrillation treated with warfarin?
Population
18,867 qualifying hospitalizations with nonrheumatic AF in a stroke-free cohort
Comparison
Racial/ethnic groups (whites, blacks, Hispanics, and Asians) and warfarin exposure
Design
Retrospective multiethnic cohort study
Follow-up
3.3 years
Authors
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May warrant enhanced ICH monitoring in nonwhite AF patients on warfarin; leaves open whether ethnicity-tailored strategies improve safety.
Cohort (n=18,867)
Does race/ethnicity affect the risk of intracranial hemorrhage in patients with atrial fibrillation treated with warfarin?
Hazard Ratio: 4.06 (95% CI 2.47–6.65)
Nonwhite patients with atrial fibrillation, particularly Asians, have a significantly higher risk of warfarin-related intracranial hemorrhage compared to white patients.
Shen et al. (2007) conducted a cohort in Atrial fibrillation (n=18,867). Nonwhite race/ethnicity (Asian, Hispanic, Black) vs. White race/ethnicity was evaluated on Intracranial hemorrhage (ICH) (HR 4.06, 95% CI 2.47 to 6.65). Among patients with atrial fibrillation, Asians (HR 4.06; 95% CI 2.47-6.65), Hispanics (HR 2.06), and blacks (HR 2.04) had a significantly higher risk of intracranial hemorrhage compared to whites.
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