Key result
Warfarin use at hospital discharge in patients with nonvalvular atrial fibrillation was associated with a lower 1-year rate of stroke or TIA (OR 0.38; 95% CI 0.17-0.85; P=0.015).
Why the study?
Does warfarin use at hospital-ED discharge reduce 1-year rate of stroke/TIA and all-cause mortality in patients with nonvalvular atrial fibrillation?
Cohort (n=1,721)
Yes
Does warfarin use at hospital-ED discharge reduce 1-year rate of stroke/TIA and all-cause mortality in patients with nonvalvular atrial fibrillation?
Odds Ratio: 0.38 (95% CI 0.17–0.85)
p-value: p=0.015
In a Middle Eastern cohort of relatively young patients with nonvalvular AF, warfarin use at discharge was associated with significantly lower 1-year rates of stroke/TIA and mortality, highlighting the clinical impact of suboptimal anticoagulation rates.
Supports discharge anticoagulation consideration in nonvalvular AF; extends real-world data in underrepresented cohorts but remains hypothesis-generating.
We describe management and outcomes of patients with nonvalvular atrial fibrillation (AF) in the Middle East. Consecutive patients with AF presenting to emergency departments (EDs) were prospectively enrolled. Among 1721 patients with nonvalvular AF, mean age was 59 ± 16 years and 44% were women. Comorbidities were common such as hypertension (59%), diabetes (33%), and coronary artery disease (33%). Warfarin was not prescribed to 40% of patients with Congestive heart failure, Hypertension, Age, Diabetes mellitus, Stroke/TIA2 score of ≥2. One-year rates of stroke/transient ischemic attack (TIA) and all-cause mortality were 4.2% and 15.3%, respectively. Warfarin use at hospital-ED discharge was independently associated with lower 1-year rate of stroke/TIA (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.17-0.85; P = .015) and all-cause mortality (OR, 0.51; 95% CI, 0.32-0.83; P = .006). Prior history of heart failure and peripheral vascular disease was independent mortality predictors. Our patients are relatively young with significant cardiovascular risk. Their anticoagulation treatment is suboptimal, and 1-year all-cause mortality and stroke/TIA event rates are relatively high.
No takes yet. Share an insight, caveat, or question.
Zubaid et al. (2014) conducted a cohort in Nonvalvular atrial fibrillation (n=1,721). Warfarin use at hospital-ED discharge vs. No warfarin use was evaluated on 1-year rate of stroke/TIA (OR 0.38, 95% CI 0.17-0.85, p=0.015). Warfarin use at hospital discharge in patients with nonvalvular atrial fibrillation was associated with a lower 1-year rate of stroke or TIA (OR 0.38; 95% CI 0.17-0.85; P=0.015).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: