A1 Journal article (refereed)
Inadequate oral anticoagulation with warfarin in women with cerebrovascular event and history of atrial fibrillation : the FibStroke study (2021)


Bah, A., Nuotio, I., Palomäki, A., Mustonen, P., Kiviniemi, T., Ylitalo, A., Hartikainen, P., Airaksinen, K. E. J., & Hartikainen, J. E. K. (2021). Inadequate oral anticoagulation with warfarin in women with cerebrovascular event and history of atrial fibrillation : the FibStroke study. Annals of Medicine, 53(1), 287-294. https://doi.org/10.1080/07853890.2021.1875499


JYU authors or editors


Publication details

All authors or editors: Bah, Aissa; Nuotio, Ilpo; Palomäki, Antti; Mustonen, Pirjo; Kiviniemi, Tuomas; Ylitalo, Antti; Hartikainen, Päivi; Airaksinen, K. E. Juhani; Hartikainen, Juha E. K.

Journal or series: Annals of Medicine

ISSN: 0785-3890

eISSN: 1365-2060

Publication year: 2021

Volume: 53

Issue number: 1

Pages range: 287-294

Publisher: Taylor & Francis

Publication country: United Kingdom

Publication language: English

DOI: https://doi.org/10.1080/07853890.2021.1875499

Publication open access: Openly available

Publication channel open access: Partially open access channel

Publication is parallel published (JYX): https://jyx.jyu.fi/handle/123456789/73886


Abstract

Background: Women with atrial fibrillation (AF) may be treated less actively with oral anticoagulation (OAC) than men.
Patients and methods: We assessed sex differences in the implementation of stroke risk stratification with CHADS2 and CHA2DS2-VASc scores and reasons not to use OAC in 1747 AF patients suffering their first cerebrovascular event after the AF diagnosis.
Results: Women were older and had more often a high stroke risk (CHADS2/CHA2DS2-VASc 2) than men (p < .001). On admission, 46.4% of women and 48.2% of men were on OAC with no sex difference (p ¼ .437). However, of patients without OAC, 74.4% of women and 49.5% of men should have been on OAC based on CHADS2/CHA2DS2-VASc 2 (p < .001). Conversely, 34.8% of men and 17.5% of women on OAC had a low or moderate risk (CHADS2/CHA2DS2-VASc 0–1, p < .001). A valid reason to omit OAC was reported in 38.6% of patients and less often in women (p < .001).
Conclusions: OAC was underused in high-risk AF patients, particularly women, but prescribed often in men with low or moderate stroke risk. Reasons for omitting OAC treatment were poorly reported, particularly for women.


Keywords: cardiovascular diseases; atrial fibrillation; anticoagulation; prescriptions; gender differences

Free keywords: atrial fibrillation (AF); oral anticoagulation (OAC); CHADS2; CHA2DS2-VASc; sex


Contributing organizations


Ministry reporting: Yes

Reporting Year: 2021

Preliminary JUFO rating: 2


Last updated on 2021-07-07 at 17:56