open access

Vol 26, No 6 (2019)
Original articles — Clinical cardiology
Published online: 2018-04-25
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Monotherapy of acetylsalicylic acid or warfarin for prevention of ischemic stroke in low-risk atrial fibrillation: A Easter Asian population-based study

Chieh-Yu Liu, Hui-Chun Chen
DOI: 10.5603/CJ.a2018.0051
·
Pubmed: 29718533
·
Cardiol J 2019;26(6):704-710.

open access

Vol 26, No 6 (2019)
Original articles — Clinical cardiology
Published online: 2018-04-25

Abstract

Background: This study aimed to investigate the effectiveness of monotherapy acetylsalicylic acid
(ASA) and warfarin for stroke prevention in low-risk atrial fibrillation (AF) by using a population-
-based cohort study in Taiwan.
Methods: A newly diagnosed low-risk AF patient cohort were identified by using National Health
Insurance Research Database (NHIRD) in Taiwan in 2008. The study cohort was observed with
a follow-up of 2 years to examine the onset of ischemic stroke (IS) (to 2010). The longitudinal data were
analyzed by using generalized estimation equations (GEE).
Results: A total of 8,065 newly-diagnosed low-risk AF patients were identified in 2008. 7.4% were
prescribed with ASA and 4.6% were prescribed with warfarin. The GEE results showed that low-risk
AF patients with hypertension who received warfarin were associated with a statistically significant
58.4% reduction of IS risk (OR = 0.416, p = 0.024, 95% CI 0.194–0.891). Additionally, low-risk AF
patients with hyperlipidemia who received warfarin were associated with a 69.3% reduction of IS risk
(OR = 0.307, p = 0.044, 95% CI 0.097–0.969).
Conclusions: Warfarin is suggested to be prescribed in preventing IS for low-stroke-risk AF patients
with hypertension and hyperlipidemia.

Abstract

Background: This study aimed to investigate the effectiveness of monotherapy acetylsalicylic acid
(ASA) and warfarin for stroke prevention in low-risk atrial fibrillation (AF) by using a population-
-based cohort study in Taiwan.
Methods: A newly diagnosed low-risk AF patient cohort were identified by using National Health
Insurance Research Database (NHIRD) in Taiwan in 2008. The study cohort was observed with
a follow-up of 2 years to examine the onset of ischemic stroke (IS) (to 2010). The longitudinal data were
analyzed by using generalized estimation equations (GEE).
Results: A total of 8,065 newly-diagnosed low-risk AF patients were identified in 2008. 7.4% were
prescribed with ASA and 4.6% were prescribed with warfarin. The GEE results showed that low-risk
AF patients with hypertension who received warfarin were associated with a statistically significant
58.4% reduction of IS risk (OR = 0.416, p = 0.024, 95% CI 0.194–0.891). Additionally, low-risk AF
patients with hyperlipidemia who received warfarin were associated with a 69.3% reduction of IS risk
(OR = 0.307, p = 0.044, 95% CI 0.097–0.969).
Conclusions: Warfarin is suggested to be prescribed in preventing IS for low-stroke-risk AF patients
with hypertension and hyperlipidemia.

Get Citation

Keywords

atrial fibrillation, acetylsalicylic acid, warfarin, ischemic stroke, hypertension, diabetes mellitus, hyperlipidemia

About this article
Title

Monotherapy of acetylsalicylic acid or warfarin for prevention of ischemic stroke in low-risk atrial fibrillation: A Easter Asian population-based study

Journal

Cardiology Journal

Issue

Vol 26, No 6 (2019)

Pages

704-710

Published online

2018-04-25

DOI

10.5603/CJ.a2018.0051

Pubmed

29718533

Bibliographic record

Cardiol J 2019;26(6):704-710.

Keywords

atrial fibrillation
acetylsalicylic acid
warfarin
ischemic stroke
hypertension
diabetes mellitus
hyperlipidemia

Authors

Chieh-Yu Liu
Hui-Chun Chen

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