Warfarin Use among Ambulatory Patients with Nonvalvular Atrial Fibrillation: The AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study

Go, Alan S.; Hylek, Elaine M.; Borowsky, Leila H.; Phillips, Kathleen A.; Selby, Joe V.; Singer, Daniel E.

doi:10.7326/0003-4819-131-12-199912210-00004

Cited by 527 publications

(441 citation statements)

References 45 publications

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“…Criteria used to identify each condition (Appendix Table 1, available at www.annals.org) have been described previously (21). Previous studies have documented the accuracy of the clinical databases used in our study for several diagnoses, including diabetes, coronary artery disease (CAD), and stroke (22,23). Diabetes diagnoses, myocardial infarction, and stroke are confirmed at chart review in 98%, 99%, and 75% of cases, respectively.…”

Section: Study Participantsmentioning

confidence: 89%

Therapy Modifications in Response to Poorly Controlled Hypertension, Dyslipidemia, and Diabetes Mellitus

et al. 2006

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Section: Study Participantsmentioning

confidence: 89%

Therapy Modifications in Response to Poorly Controlled Hypertension, Dyslipidemia, and Diabetes Mellitus

et al. 2006

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“…Clinical outcomes were identified by searching computerized hospitalization and billing databases for relevant ICD‐9 codes (Data S1), and only the first event of each type was recorded. The diagnosis of ischemic stroke ( ICD‐9 code 433.01, 433.11, 433.21, 433.31, 433.81, 433.91, 434.01, 434.11, 434.91, or 436) was based on a relevant code in the primary hospital discharge position and ICH on a primary or secondary hospital discharge diagnosis 10, 15. Hospitalizations for extracranial hemorrhage were identified by appropriate ICD‐9 codes in the primary position.…”

Section: Methodsmentioning

confidence: 99%

“…We used the virtual data warehouse to obtain information on age, sex, race, relevant medical history, comorbid conditions, and other cardiovascular risk factors at baseline using previously validated approaches based on ICD‐9 diagnosis and procedure codes, Current Procedure Terminology procedure codes, laboratory records, and pharmacy records 15, 16…”

Section: Methodsmentioning

confidence: 99%

Anxiety, Depression, and Adverse Clinical Outcomes in Patients With Atrial Fibrillation Starting Warfarin: Cardiovascular Research Network WAVE Study

Baumgartner

Fan

Fang

et al. 2018

JAHA

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BackgroundAnxiety and depression are associated with worse outcomes in several cardiovascular conditions, but it is unclear whether they affect outcomes in atrial fibrillation (AF). In a large diverse population of adults with AF, we evaluated the association of diagnosed anxiety and/or depression with stroke and bleeding outcomes.Methods and ResultsThe Cardiovascular Research Network WAVE (Community‐Based Control and Persistence of Warfarin Therapy and Associated Rates and Predictors of Adverse Clinical Events in Atrial Fibrillation and Venous Thromboembolism) Study included adults with AF newly starting warfarin between 2004 and 2007 within 5 health delivery systems in the United States. Diagnosed anxiety and depression and other patient characteristics were identified from electronic health records. We identified stroke and bleeding outcomes from hospitalization databases using validated International Classification of Diseases, Ninth Revision (ICD‐9), codes. We used multivariable Cox regression to assess the relation between anxiety and/or depression with outcomes after adjustment for stroke and bleeding risk factors. In 25 570 adults with AF initiating warfarin, 490 had an ischemic stroke or intracranial hemorrhage (1.52 events per 100 person‐years). In multivariable analyses, diagnosed anxiety was associated with a higher adjusted rate of combined ischemic stroke and intracranial hemorrhage (hazard ratio, 1.52; 95% confidence interval, 1.01–2.28). Results were not materially changed after additional adjustment for patient‐level percentage of time in therapeutic anticoagulation range on warfarin (hazard ratio, 1.56; 95% confidence interval, 1.03–2.36). In contrast, neither isolated depression nor combined depression and anxiety were significantly associated with outcomes.ConclusionsDiagnosed anxiety was independently associated with increased risk of combined ischemic stroke and intracranial hemorrhage in adults with AF initiating warfarin that was not explained by differences in risk factors or achieved anticoagulation quality.

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“…Non-valvular atrial fibrillation was defined as a discharge diagnosis of atrial fibrillation or flutter (ICD-10 I48), without previous diagnoses of mitral or aortic valve disease (ICD-8 394, 395, 396, 4240, and 4241; ICD-10 I05, I06, I34, and I35) or mitral or aortic valve surgery (procedure codes KFK, KFM, and KFP). The same definition has been applied in other cohort analyses [22][23][24]. Patients with retinal venous occlusion (ICD-8 37703 or ICD-10 H348) or retinal arterial occlusion (ICD-8 37702 or ICD-10 H340-342) before the index date were identified from the National Patient Registry, and whether patients developed a retinal occlusion was recorded continuously during follow-up.…”

Section: Study Populationmentioning

confidence: 99%

Retinal vein and artery occlusions: a risk factor for stroke in atrial fibrillation

Christiansen

Lip

Lamberts

et al. 2013

Journal of Thrombosis and Haemostasis

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Summary. Background: Retinal vascular occlusions may constitute an independent risk factor for stroke in patients with atrial fibrillation. Methods: We performed a retrospective study on a nationwide cohort with atrial fibrillation from 1997 to 2008. The rate of stroke/systemic thromboembolism (TE)/transitory ischemic attack (TIA) was determined for atrial fibrillation patients with and without a history of retinal vascular occlusion. A Cox regression analysis, adjusted for risk factors and medications, was performed to determine the independent predictive value of retinal arterial or venous occlusion for the risk of ischemic stroke, TE or TIA in atrial fibrillation patients. Results: We included 87 202 patients with nonvalvular atrial fibrillation. At baseline, a history of retinal arterial occlusion was diagnosed in 224 patients (0.26%) and a history of retinal venous occlusion in 361 (0.41%). Patients without retinal occlusion had a rate of stroke/TE/ TIA of 4.52 (95% confidence interval [CI] 4.44-4.60). For patients with retinal arterial occlusion, the rate of stroke/ TE/TIA was 8.16 (95% CI 6.35-10.49) per 100 personyears, and for patients with retinal venous occlusion it was 7.28 (95% CI 5.93-8.94) per 100 person-years. In multivariate analysis, both retinal arterial occlusions (hazard ratio [HR] 1.39, 95% CI 1.08-1.79) and retinal venous occlusions (HR 1.26, 95% CI 1.02-1.54) were associated with an increased risk of future stroke/TE/TIA. Conclusions: A history of retinal arterial or retinal venous occlusion is associated with an increased risk of stroke/TE/TIA in patients with atrial fibrillation. Thus, prior retinal vascular occlusion may be considered as a previous thromboembolic event when evaluating stroke risk in patients with atrial fibrillation.

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Warfarin Use among Ambulatory Patients with Nonvalvular Atrial Fibrillation: The AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study

Cited by 527 publications

References 45 publications

Therapy Modifications in Response to Poorly Controlled Hypertension, Dyslipidemia, and Diabetes Mellitus

Therapy Modifications in Response to Poorly Controlled Hypertension, Dyslipidemia, and Diabetes Mellitus

Anxiety, Depression, and Adverse Clinical Outcomes in Patients With Atrial Fibrillation Starting Warfarin: Cardiovascular Research Network WAVE Study

Retinal vein and artery occlusions: a risk factor for stroke in atrial fibrillation

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