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Impact of prescription patterns of antithrombotic treatment on atrial fibrillation-related ischemic stroke.
- Source :
-
Current medical research and opinion [Curr Med Res Opin] 2021 Mar; Vol. 37 (3), pp. 357-365. Date of Electronic Publication: 2021 Jan 19. - Publication Year :
- 2021
-
Abstract
- Objective: To analyze the temporal trends of atrial fibrillation (AF)-related ischemic stroke (IS) and their relationship with the prescription patterns of antithrombotic treatment from 2013 to 2019 in the Health Assistance Area of a regional hospital.<br />Methods: First, a retrospective ecological study of aggregate data to analyze the annual incidence of IS between 2013 and 2019 was performed. Second, we selected those patients diagnosed with AF between 2013 and 2019 and performed a retrospective longitudinal study to assess the role of antithrombotic therapy in the development of AF-related IS.<br />Results: During this period, whereas the annual incidence of IS remained stable (from 1.3 in 2013 to 1.2 cases per 1000 inhabitants in 2019; adjusted P for trend .829), the annual incidence of AF-related IS decreased over time (from 23.8 to 18.8 cases per 1000 inhabitants, respectively; adjusted P for trend .001). Among AF patients, the use of direct oral anticoagulants increased from 5.5% to 46.8%, while the prescription of antiplatelets and vitamin K antagonists decreased from 21.9% to 6.0% and from 63.8% to 36.1%, respectively. Overall, the use of oral anticoagulants increased from 69.3% to 82.9%; p < .001. Patients under antiplatelet agents had a higher probability of presenting IS than those patients taking oral anticoagulants, either vitamin K antagonists or direct oral anticoagulants (adjusted OR 1.89; 95% CI 1.52-2.37; p < .001).<br />Conclusions: The prescription of oral anticoagulants, particularly direct oral anticoagulants, has increased from 2013 to 2019 in our Health Assistance Area. This increase might partially explain the reduction in AF-related IS.
- Subjects :
- Administration, Oral
Anticoagulants therapeutic use
Fibrinolytic Agents therapeutic use
Humans
Longitudinal Studies
Prescriptions
Retrospective Studies
Risk Factors
Treatment Outcome
Atrial Fibrillation complications
Atrial Fibrillation drug therapy
Atrial Fibrillation epidemiology
Brain Ischemia complications
Brain Ischemia drug therapy
Brain Ischemia epidemiology
Ischemic Stroke
Stroke drug therapy
Stroke epidemiology
Stroke etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1473-4877
- Volume :
- 37
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Current medical research and opinion
- Publication Type :
- Academic Journal
- Accession number :
- 33326304
- Full Text :
- https://doi.org/10.1080/03007995.2020.1865892