TY  - JOUR
T1  - Temporal trends in ischemic stroke and anticoagulation therapy among medicare patients with atrial fibrillation: A 15-year perspective (1992-2007)
AU  - Shroff GR, Solid CA, Herzog CA
Y1  - 2013/01/28
N1  - 10.1001/jamainternmed.2013.1579
JO  - JAMA Internal Medicine
SP  - 159
EP  - 160
VL  - 173
IS  - 2
N2  - 
Atrial fibrillation (AF) is an independent, modifiable risk factor for ischemic stroke1 and independently associated with increased mortality.2 Nonvalvular AF is associated with a nearly 5-fold higher risk of ischemic stroke; this risk progressively increases with age.3 In a meta-analysis involving 29 clinical studies and 28 044 patients, judicious antithrombotic therapy with adjusted-dose warfarin was shown to reduce risk related to ischemic stroke by nearly 60% and mortality by approximately 25%, without significant increases in hemorrhagic stroke.4 However, diffusion of evidence-based knowledge from clinical trials into routine clinical practice demonstrates a significant time lag and evidence-to-practice gap; rates of ischemic stroke are therefore higher in clinical practice.5 We sought to extend previous work by Lakshminarayan et al6 to examine temporal trends in ischemic and hemorrhagic stroke rates and warfarin use in the Medicare population over a span of 15 years.

SN  - 2168-6106
M3  - doi: 10.1001/jamainternmed.2013.1579
UR  - http://dx.doi.org/10.1001/jamainternmed.2013.1579
ER  -