Increased short-term risk of thrombo-embolism or death after interruption of warfarin treatment in patients with atrial fibrillation
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Standard
Increased short-term risk of thrombo-embolism or death after interruption of warfarin treatment in patients with atrial fibrillation. / Raunsø, Jakob; Selmer, Christian; Olesen, Jonas Bjerring; Charlot, Mette Gitz; Olsen, Anne-Marie S; Bretler, Ditte-Marie; Nielsen, Jørn Dalsgaard; Dominguez, Helena; Gadsbøll, Niels; Køber, Lars; Gislason, Gunnar H; Torp-Pedersen, Christian; Hansen, Morten Lock.
I: European Heart Journal (Online), Bind 33, Nr. 15, 08.2012, s. 1886-92.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Increased short-term risk of thrombo-embolism or death after interruption of warfarin treatment in patients with atrial fibrillation
AU - Raunsø, Jakob
AU - Selmer, Christian
AU - Olesen, Jonas Bjerring
AU - Charlot, Mette Gitz
AU - Olsen, Anne-Marie S
AU - Bretler, Ditte-Marie
AU - Nielsen, Jørn Dalsgaard
AU - Dominguez, Helena
AU - Gadsbøll, Niels
AU - Køber, Lars
AU - Gislason, Gunnar H
AU - Torp-Pedersen, Christian
AU - Hansen, Morten Lock
PY - 2012/8
Y1 - 2012/8
N2 - AIMS: It is presently unknown whether patients with atrial fibrillation (AF) are at increased risk of thrombo-embolic adverse events after interruption of warfarin treatment. The purpose of this study was to assess the risk and timing of thrombo-embolism after warfarin treatment interruption.METHODS AND RESULTS: A retrospective, nationwide cohort study of all patients in Denmark treated with warfarin after a first hospitalization with AF in the period 1997-2008. Incidence rate ratios (IRRs) of thrombo-embolic events and all-cause mortality were calculated using the Poisson regression analyses. In total, 48 989 AF patients receiving warfarin treatment were included. Of these, 35 396 patients had at least one episode of warfarin treatment interruption. In all, 8255 deaths or thrombo-embolic events occurred during treatment interruption showing an initial clustering of events with 2717, 835, 500, and 427 events occurring during 0-90, 91-180, 181-270, and 271-360 days after treatment interruption, respectively. Correspondingly, the crude incidence rates were 31.6, 17.7, 12.3, and 11.4 events per 100 patient-years. In a multivariable analysis, the first 90-day interval of treatment interruption was associated with a markedly higher risk of death or thrombo-embolism (IRR 2.5; 95% confidence interval 2.3-2.8) vs. the interval of 271-360 days.CONCLUSION: In patients with AF, an interruption of warfarin treatment is associated with a significantly increased short-term risk of death or thrombo-embolic events within the first 90 days of treatment interruption.
AB - AIMS: It is presently unknown whether patients with atrial fibrillation (AF) are at increased risk of thrombo-embolic adverse events after interruption of warfarin treatment. The purpose of this study was to assess the risk and timing of thrombo-embolism after warfarin treatment interruption.METHODS AND RESULTS: A retrospective, nationwide cohort study of all patients in Denmark treated with warfarin after a first hospitalization with AF in the period 1997-2008. Incidence rate ratios (IRRs) of thrombo-embolic events and all-cause mortality were calculated using the Poisson regression analyses. In total, 48 989 AF patients receiving warfarin treatment were included. Of these, 35 396 patients had at least one episode of warfarin treatment interruption. In all, 8255 deaths or thrombo-embolic events occurred during treatment interruption showing an initial clustering of events with 2717, 835, 500, and 427 events occurring during 0-90, 91-180, 181-270, and 271-360 days after treatment interruption, respectively. Correspondingly, the crude incidence rates were 31.6, 17.7, 12.3, and 11.4 events per 100 patient-years. In a multivariable analysis, the first 90-day interval of treatment interruption was associated with a markedly higher risk of death or thrombo-embolism (IRR 2.5; 95% confidence interval 2.3-2.8) vs. the interval of 271-360 days.CONCLUSION: In patients with AF, an interruption of warfarin treatment is associated with a significantly increased short-term risk of death or thrombo-embolic events within the first 90 days of treatment interruption.
KW - Aged
KW - Aged, 80 and over
KW - Anticoagulants
KW - Atrial Fibrillation
KW - Cause of Death
KW - Denmark
KW - Female
KW - Hospitalization
KW - Humans
KW - Male
KW - Retrospective Studies
KW - Risk Factors
KW - Thromboembolism
KW - Warfarin
KW - Withholding Treatment
U2 - 10.1093/eurheartj/ehr454
DO - 10.1093/eurheartj/ehr454
M3 - Journal article
C2 - 22199117
VL - 33
SP - 1886
EP - 1892
JO - European Heart Journal
JF - European Heart Journal
SN - 0195-668X
IS - 15
ER -
ID: 157441167