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