Original Article
Effect of Intensity of Oral Anticoagulation on Stroke Severity and Mortality in Atrial Fibrillation
N Engl J Med 2003; 349:1019-1026September 11, 2003
- Abstract
Background
The incidence of stroke in patients with atrial fibrillation is greatly reduced by oral anticoagulation, with the full effect seen at international normalized ratio (INR) values of 2.0 or greater. The effect of the intensity of oral anticoagulation on the severity of atrial fibrillation–related stroke is not known but is central to the choice of the target INR.
Methods
We studied incident ischemic strokes in a cohort of 13,559 patients with nonvalvular atrial fibrillation. Strokes were identified through hospitalization data bases and validated on the basis of medical records, which also provided information on the use of warfarin or aspirin, the INR at admission, and coexisting illnesses. The severity of stroke was graded according to a modified Rankin scale. Thirty-day mortality was ascertained from hospitalization and mortality files.
Results
Of 596 ischemic strokes, 32 percent occurred during warfarin therapy, 27 percent during aspirin therapy, and 42 percent during neither type of therapy. Among patients who were taking warfarin, an INR of less than 2.0 at admission, as compared with an INR of 2.0 or greater, independently increased the odds of a severe stroke in a proportional-odds logistic-regression model (odds ratio, 1.9; 95 percent confidence interval, 1.1 to 3.4) across three severity categories and the risk of death within 30 days (hazard ratio, 3.4; 95 percent confidence interval, 1.1 to 10.1). An INR of 1.5 to 1.9 at admission was associated with a mortality rate similar to that for an INR of less than 1.5 (18 percent and 15 percent, respectively). The 30-day mortality rate among patients who were taking aspirin at the time of the stroke was similar to that among patients who were taking warfarin and who had an INR of less than 2.0.
Conclusions
Among patients with nonvalvular atrial fibrillation, anticoagulation that results in an INR of 2.0 or greater reduces not only the frequency of ischemic stroke but also its severity and the risk of death from stroke. Our findings provide further evidence against the use of lower INR target levels in patients with atrial fibrillation.
Media in This Article
Figure 1
Kaplan–Meier Estimates of Survival in the 30 Days after an Ischemic Stroke among Patients with Nonvalvular Atrial Fibrillation, According to the Antithrombotic-Medication Status at Admission.Table 1
Clinical Characteristics of 596 Patients with Nonvalvular Atrial Fibrillation Who Had an Ischemic Stroke, According to the Antithrombotic-Medication Status at Admission.Article Activity
- Article
Nonvalvular atrial fibrillation increases the risk of ischemic stroke by a factor of five, presumably by an atrioembolic mechanism.1-4 Such cardioembolic strokes are more severe than other types of ischemic stroke.5-8 Consistent with these observations are data from numerous population-based studies showing that mortality rates are higher for strokes associated with atrial fibrillation.9-15 Randomized trials have shown that warfarin is highly effective in preventing stroke in patients with atrial fibrillation, most likely by minimizing the formation of atrial thrombi.4,16,17 The full efficacy of anticoagulation is seen only at an international normalized ratio (INR) of 2.0 and above.18,19 Although the effect of oral anticoagulants on the frequency of stroke is clear, their effect on the severity of stroke and stroke-related mortality among patients with atrial fibrillation has been less well studied.8,20 In particular, the effect of the INR on the severity of stroke in such patients is unknown. We assessed the effect of the intensity of anticoagulation on the severity of ischemic stroke and on the 30-day mortality rate after stroke in a large cohort of patients with nonvalvular atrial fibrillation. We also determined the rates of ischemic stroke and intracranial hemorrhage according to the intensity of anticoagulation to help physicians and patients make better-informed decisions regarding optimal INR values.
Methods
Study Population
The study cohort has been described previously.21 We identified all patients 18 years or older enrolled in Kaiser Permanente of Northern California, a large, integrated health care system, who had nonvalvular atrial fibrillation between July 1, 1996, and December 31, 1997. Nonvalvular atrial fibrillation was identified on the basis of physician-assigned diagnoses of atrial fibrillation during a routine visit (International Classification of Diseases, 9th revision, Clinical Modification [ICD-9-CM], code 427.31), electrocardiographic data bases, or both.22 Patients with diagnosed mitral stenosis or heart-valve repair or replacement, transient perioperative atrial fibrillation, or recent hyperthyroidism were excluded. The final cohort included 13,559 patients.
Definition and Identification of Events
From each patient's index date through August 31, 1999, we identified ischemic strokes by searching comprehensive automated hospitalization and billing-claims data bases for primary ICD-9-CM discharge diagnoses for ischemic stroke (codes 433.00 to 433.01, 433.10 to 433.11, 433.20 to 433.21, 433.30 to 433.31, 434.00 to 434.01, 434.10 to 434.11, 434.90 to 434.91, and 436.0).22 Medical records were reviewed by a clinical-outcomes committee of three physicians using a formal protocol. Cranial computed tomographic scans or magnetic resonance imaging studies (or both) were available for 98 percent of the patients. A validated ischemic stroke was defined as a neurologic deficit of sudden onset that persisted for more than 24 hours, corresponded to a vascular territory in the absence of primary hemorrhage, and was not explained by other causes (e.g., trauma, infection, or vasculitis). Patients with strokes that occurred during hospitalization or as a complication of a procedure were excluded. Patients who were evaluated in the emergency room and then discharged were included if there was evidence that the neurologic deficit had persisted for more than 24 hours. All events had to be independently verified by two committee members. Disagreements were resolved by a consensus of all three committee members. Any remaining disagreements were adjudicated by a consulting neurologist.
Characteristics of the Patients
Information on clinical variables, obtained from medical charts, included a history of ischemic stroke; a history of cerebrovascular disease, defined by known carotid or vertebrobasilar atherosclerosis or prior carotid endarterectomy; congestive heart failure; coronary artery disease; diabetes mellitus; hypertension; and acute in-hospital treatment with anticoagulants or thrombolytic therapy. Data on age, sex, and racial or ethnic group were obtained from administrative data bases.21
Antithrombotic Medication and INR at Admission
The use of warfarin or aspirin at the time of the outpatient stroke was determined from a review of emergency-room and hospital-admission notes. The INR value at the time of presentation was recorded. The use of warfarin or aspirin was explicitly noted in the medication list obtained at admission in the case of 95 percent of patients. Documentation was incomplete for 28 patients. We subsequently determined that five of these patients had used warfarin on the basis of serial outpatient prescriptions for warfarin recorded in the pharmacy data base of the health plan or recording of INR values up to the time of the stroke in the laboratory data base (or both). We categorized the 23 remaining patients as taking neither warfarin nor aspirin. The INR value at admission was missing for 10 of the 201 patients who were taking warfarin when they were admitted for an ischemic stroke. For two of these patients, we used an outpatient INR value determined within 72 hours before the event. The remaining eight patients were excluded. The antecedent level of anticoagulation control was assessed by calculation of the mean INR for each patient during the six months before the stroke. Ninety-three percent of the patients who had been taking warfarin had such prestroke INR values available.
Severity of Stroke and 30-Day Mortality
Because the focus of our study was the effect of prior oral anticoagulant therapy on the severity of stroke, we excluded 14 patients who had an intracerebral hemorrhage after in-hospital treatment with thrombolytic or heparin therapy for their stroke (3 were taking aspirin on admission, 5 were taking warfarin and had an INR of less than 2.0, and 6 were taking neither aspirin nor warfarin). No patient whose INR was 2.0 or greater on admission had a spontaneous intracerebral hemorrhage after the stroke.
We used the modified Rankin scale adapted by the Oxfordshire Community Stroke Project to classify the functional deficit at hospital discharge, on the basis of a physician's review of the medical record.23 Patients with a score of 1 or 2 were classified as having minor strokes with a residual neurologic deficit that did not interfere with independent living. Patients with a score of 3 or 4 were classified as having major strokes with residual neurologic impairment that prevented independent living. A score of 5 denoted a severe stroke that resulted in total dependence and was usually associated with depressed consciousness. Clinical information was insufficient to determine the extent of the neurologic deficit at discharge for 15 patients (3 patients had been taking aspirin at admission, 2 had been taking warfarin and had an INR of less than 2.0, and 10 had been taking neither aspirin nor warfarin). These 15 patients were excluded from the analyses of the severity of stroke but were included in the analyses of 30-day mortality. We did not formally assess the mechanism of stroke.3
Death from any cause during hospitalization was ascertained by a review of the medical charts, and deaths that occurred after discharge were identified by a review of the health plan's records and the California death registry.24 Thirty-day follow-up data on vital status were complete.
Rates of Ischemic Stroke and Intracranial Hemorrhage According to the Intensity of Anticoagulation
We have previously reported on the effect of warfarin treatment on stroke rates in our cohort.25 Here, we report on the incidence of ischemic stroke and intracranial hemorrhage according to the INR among patients who were taking anticoagulant agents. We focus on intracranial hemorrhage because it is the category of hemorrhagic toxicity that approximates ischemic stroke in terms of clinical and functional effect. The duration of treatment within designated INR ranges was calculated with use of an adapted linear interpolation method.26 Warfarin status was assigned with use of a previously described algorithm incorporating pharmacy prescription information with laboratory INR data.21 To minimize error in interpolation, gaps in INR measurement exceeding 56 days were excluded. Events that occurred during these periods were not included in the INR-specific analyses of event rates.
Statistical Analysis
The severity of stroke was categorized according to the extent of the neurologic deficit at discharge: severe deficit (or in-hospital death), major deficit, or minor or no deficit. The correlation between categories of stroke severity and 30-day mortality was assessed with use of the Mantel–Haenszel chi-square trend test.27 We used proportional-odds ordinal logistic-regression models that allowed us to compare multiple outcome categories in order to assess the independent effect of antithrombotic treatment on the severity of stroke at hospital discharge.28 This approach fits a uniform log cumulative odds of progression across our three categories of severity as a function of antithrombotic therapy at admission and other covariates. The independent effect of antithrombotic therapy on 30-day mortality was assessed with the use of Cox proportional-hazards regression models.29 The proportional odds and the proportional-hazards assumptions were met for these regression models. Kaplan–Meier survival curves were constructed for the 30-day period after stroke for the four antithrombotic medication groups, and these groups were compared with use of the log-rank test.29
The study was approved by the institutional review boards at the Kaiser Permanente Medical Care Program of Northern California and at Massachusetts General Hospital. Because of the nature of the study, the requirement for informed consent was waived.
Results
Base-Line Clinical Features
During the study period, 618 patients with atrial fibrillation and ischemic stroke were identified. Twenty-two were excluded from the analysis: 8 because of missing INR values at admission and 14 because they had an intracerebral hemorrhage after thrombolytic or heparin therapy for their stroke. Of the remaining 596 patients, 188 (32 percent) were taking warfarin at the time of their stroke, 160 (27 percent) were taking aspirin, and 248 (42 percent) were taking neither warfarin nor aspirin (Table 1Table 1
Clinical Characteristics of 596 Patients with Nonvalvular Atrial Fibrillation Who Had an Ischemic Stroke, According to the Antithrombotic-Medication Status at Admission.). Overall, the mean age of the patients was 78 years, and 55 percent were women. Approximately one third of the patients had a history of congestive heart failure, coronary heart disease, or stroke. Nearly 70 percent had hypertension. The warfarin group had a slightly lower mean age than the other two groups, had fewer women, and had a higher prevalence of congestive heart failure, coronary heart disease, diabetes mellitus, and prior stroke. The median INR on admission was 1.7 in the warfarin group, and 62 percent of these values were less than 2.0. The antecedent level of anticoagulation control was nearly identical for patients with an INR of 2.0 or greater at the time of admission and those with an INR of less than 2.0, with a median INR of 2.2 in both groups.Severity of Stroke and 30-Day Mortality
The severity of stroke was strongly correlated with 30-day mortality (P<0.001). Thirty-nine percent of patients with a severe stroke died within 30 days after discharge, as compared with 13 percent of those with a major deficit, 1 percent of those with a minor deficit, and none of those without neurologic sequelae.
Intensity of Anticoagulation and Severity of Stroke
Among patients taking warfarin, 15 percent of those with an INR of less than 2.0 either died before discharge or were discharged after having a severe stroke, as compared with 5 percent of patients who had an INR of 2.0 or greater at presentation (Table 2Table 2
Severity of the Neurologic Deficit at Discharge and 30-Day Mortality Rates, According to the Antithrombotic-Medication Status and International Normalized Ratio (INR) at Admission.). The proportion of patients who had a severe or fatal stroke did not differ significantly between those with an admission INR of 1.5 to 1.9 and those with an INR of less than 1.5. Twenty-two percent of patients who were not taking antithrombotic medication at the time of the stroke died before discharge or were discharged with a severe deficit, as compared with 13 percent of those taking aspirin.After adjustment for potential confounders in the proportional-odds model, the medication group remained an independent risk factor for the severity of stroke when patients who had an INR of 2.0 or greater were compared with those who had an INR of less than 2.0 or those who were taking neither aspirin nor warfarin (Table 3Table 3
Independent Predictors of the Severity of Ischemic Stroke in Patients with Nonvalvular Atrial Fibrillation.).Intensity of Anticoagulation and 30-Day Mortality
The 30-day mortality rate among patients who were taking neither warfarin nor aspirin when they had an ischemic stroke was 24 percent (Table 2 and Figure 1Figure 1
Kaplan–Meier Estimates of Survival in the 30 Days after an Ischemic Stroke among Patients with Nonvalvular Atrial Fibrillation, According to the Antithrombotic-Medication Status at Admission.). Among patients who were taking warfarin at the time of the stroke and who had an INR of 2.0 or greater, 6 percent died within 30 days, as compared with 16 percent of those with an INR of less than 2.0. The 30-day mortality rate was essentially the same among patients who were admitted with an INR between 1.5 and 1.9 and those with an INR of less than 1.5 (18 percent and 15 percent, respectively). The 30-day mortality rate among patients who were taking aspirin when they had a stroke was 15 percent, which was nearly identical to the rate among patients who were taking warfarin and whose INR was less than 2.0.As compared with an INR of 2.0 or greater, an INR of less than 2.0 at the time of stroke conferred an adjusted relative hazard of 3.4 for death within 30 days (95 percent confidence interval, 1.1 to 10.1) (Table 4Table 4
Independent Risk Factors for 30-Day Mortality after Ischemic Stroke in Patients with Nonvalvular Atrial Fibrillation.). Patients who were taking neither warfarin nor aspirin at the time of the stroke had the highest hazard ratio for 30-day mortality (4.9), as compared with those who were taking warfarin and who had an INR of 2.0 or greater. Among patients who were taking aspirin, the hazard ratio was 2.5, but the confidence interval included a hazard ratio of 1.0. Other independent risk factors for 30-day mortality included older age, congestive heart failure, and diabetes mellitus (Table 4).Intensity of Anticoagulation and Rates of Stroke and Intracranial Hemorrhage
To provide a more comprehensive accounting of the clinical sequelae of various INR values, we calculated the incidence rates of ischemic stroke and intracranial hemorrhage according to the INR among the patients who were taking warfarin (Table 5Table 5
Incidence Rates of Ischemic Stroke and Intracranial Hemorrhage among Patients with Nonvalvular Atrial Fibrillation Who Were Taking Warfarin, According to the International Normalized Ratio (INR) at the Time of the Stroke.). The rate of ischemic stroke was highest at INR values of less than 2.0, especially values of less than 1.5. By contrast, there was no marked absolute increase in the rate of intracranial hemorrhage at INR values of less than 4.0.Discussion
Prior studies have demonstrated that the incidence of ischemic stroke among patients with atrial fibrillation is greatly reduced by warfarin therapy that results in an INR of at least 2.0, a relation confirmed by our results.18,19 We also found that an INR of 2.0 or greater markedly reduces the severity of stroke and the short-term mortality rate. Patients with atrial fibrillation and an INR of less than 2.0 who had an ischemic stroke faced a risk of death within 30 days that was more than three times the risk among patients with an INR of 2.0 or greater. The outcomes were essentially equally poor among warfarin users with an INR of 1.5 to 1.9 at admission and those with an admission INR of less than 1.5. The outcome was even worse for those who were receiving no antithrombotic medication. The outcome among patients who were taking aspirin when they had a stroke was similar to that among patients who were taking warfarin and whose admission INR was less than 2.0. The lessened severity of stroke associated with more intense anticoagulation may reflect a reduced proportion of strokes from a cardiac source, a smaller thrombus, or both.3,5,8
Analyses relating the severity of stroke in patients with atrial fibrillation to the intensity of anticoagulation require large numbers of subjects who have a stroke while taking anticoagulants. Given the efficacy of anticoagulants for atrial fibrillation, it is difficult to find adequate numbers of subjects. In our cohort, there were 596 analyzable ischemic strokes, with 188 occurring among patients who were taking warfarin. By contrast, among five early primary-prevention trials of patients with atrial fibrillation there were only 27 strokes among patients treated with warfarin, and in the three Stroke Prevention in Atrial Fibrillation trials combined, there were only 25 strokes among those treated with adjusted-dose warfarin.8,16
Our results have a direct bearing on the decisions regarding the use of anticoagulant therapy in patients with atrial fibrillation and the target INR level. Guidelines and formal decision analyses have focused exclusively on the efficacy of warfarin in preventing stroke in patients with atrial fibrillation.30-35 Our findings highlight an important incremental benefit of anticoagulation: strokes that occur among patients with adequate anticoagulation are far less likely to result in severe disability or death. In formal utility assessments, patients rate strokes very differently, depending on the severity of the resulting deficits. In particular, patients frequently rate severely disabling stroke as equivalent to or worse than death.36 Recent guidelines of the American College of Cardiology–American Heart Association–European Society for Cardiology suggest the use of a lower INR target for certain patients with atrial fibrillation who are older than 75 years of age.35 Our data indicate that an INR of less than 2.0 will substantially increase the likelihood of death and severe disability from atrial fibrillation–related stroke.18,37-42 We also observed little additional risk of intracranial hemorrhage with the use of warfarin until INR values exceeded 3.9. These findings weigh against the use of target INR values below 2.0.
Potential limitations of our study should be acknowledged. Ours was an observational assessment of the effect of treatment. Randomized trials of lower levels of anticoagulation would be difficult to implement, given prior negative results of such an approach, and the numbers of strokes would probably be too small for an assessment of the effect on the severity of stroke.18,19 We observed strong effects while simultaneously controlling for other important determinants of the outcome. Residual confounding by indication is particularly unlikely in our central comparison of two levels of anticoagulation, since both groups of patients were prescribed warfarin and had very similar INR values in the six months preceding their strokes.43 It remains possible that some patients who had a minor stroke either did not seek medical care or were treated as outpatients. The 30-day mortality rate in the group of patients in our study who were not receiving anticoagulant therapy (24 percent) was similar to 30-day mortality rates for atrial fibrillation–related stroke in such population-based studies as the Framingham Study (25 percent),15 the Oxfordshire Community Stroke Project (23 percent),9,23 and the Italian Acute Stroke Study (27 percent),14 arguing against significant bias in our ascertainment of stroke. Furthermore, it is highly unlikely that the rates of hospitalization for minor strokes would be systematically disproportionate on the basis of the use or intensity of anticoagulation.
In this study of ischemic strokes in a large cohort of patients with nonvalvular atrial fibrillation, therapeutic anticoagulation resulting in an INR of 2.0 or greater at the time of the stroke was associated with less severe neurologic deficit than the absence of antithrombolytic therapy or therapy that resulted in a lower INR. The 30-day mortality rate was 6 percent among patients who were taking warfarin and who had an INR of 2.0 or greater, as compared with 16 percent among those who were taking warfarin and who had an INR of less than 2.0, 15 percent among those who were taking aspirin, and 24 percent among those who were taking neither aspirin nor warfarin. There was no significant difference in mortality rates between patients taking warfarin who had an INR of 1.5 to 1.9 and those taking warfarin who had an INR of less than 1.5. The risk of intracranial hemorrhage in our cohort did not increase until INR values exceeded 3.9. Our results provide further support for the use of anticoagulation to achieve an INR of 2.0 or greater (e.g., 2.5) in patients with nonvalvular atrial fibrillation.
Supported by a grant from the National Institute on Aging (5 R01 AG15478).
Drs. Hylek and Singer report having received grant support from DuPont Pharma, now Bristol-Myers Squibb.
We are indebted to Dr. Philip A. Wolf of Boston University School of Medicine for providing expert consultation in neurology and epidemiology and to Kathleen A. Phillips and Angela M. Capra, M.A., of the Division of Research, Kaiser Permanente of Northern California, for providing technical assistance.
Source Information
From the General Medicine Division, Clinical Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston (E.M.H., Y.C., L.E.H., D.E.S.); the Division of Research, Kaiser Permanente of Northern California, Oakland (A.S.G., N.G.J., J.V.S.); and the Departments of Epidemiology, Biostatistics, and Medicine, University of California, San Francisco, San Francisco (A.S.G.).
Address reprint requests to Dr. Hylek at the General Medicine Division, Clinical Epidemiology Unit, Massachusetts General Hospital, 50 Staniford St., 9th Fl., Boston, MA 02114.
- References
References
1
Wolf PA ,Abbott RD ,Kannel WB . Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke 1991;22:983-988
CrossRef | Web of Science | Medline2
Britton M ,Gustafsson C . Non-rheumatic atrial fibrillation as a risk factor for stroke. Stroke 1985;16:182-188
CrossRef | Web of Science | Medline3
Bogousslavsky J ,Van Melle G ,Regli F ,Kappenberger L . Pathogenesis of anterior circulation stroke in patients with nonvalvular atrial fibrillation: the Lausanne Stroke Registry. Neurology 1990;40:1046-1050
Web of Science | Medline4
Manning WJ ,Silverman DI ,Waksmonski CA ,Oettgen P ,Douglas PS . Prevalence of residual left atrial thrombi among patients with acute thromboembolism and newly recognized atrial fibrillation. Arch Intern Med 1995;155:2193-2198
CrossRef | Web of Science | Medline5
Longstreth WT Jr ,Bernick C ,Fitzpatrick A , et al. Frequency and predictors of stroke death in 5,888 participants in the Cardiovascular Health Study. Neurology 2001;56:368-375
Web of Science | Medline6
Sherman DG ,Goldman L ,Whiting RB ,Jurgensen K ,Kaste M ,Easton JD . Thromboembolism in patients with atrial fibrillation. Arch Neurol 1984;41:708-710
Web of Science | Medline7
Miller VT ,Pearce LA ,Feinberg WM ,Rothrock JF ,Anderson DC ,Hart RG . Differential effect of aspirin versus warfarin on clinical stroke types in patients with atrial fibrillation. Neurology 1996;46:238-240
Web of Science | Medline8
Hart RG ,Pearce LA ,Miller VT , et al. Cardioembolic vs. noncardioembolic strokes in atrial fibrillation: frequency and effect of antithrombotic agents in the Stroke Prevention in Atrial Fibrillation studies. Cerebrovasc Dis 2000;10:39-43
CrossRef | Web of Science | Medline9
Sandercock P ,Bamford J ,Dennis M , et al. Atrial fibrillation and stroke: prevalence in different types of stroke and influence on early and long term prognosis (Oxfordshire community stroke project). BMJ 1992;305:1460-1465
CrossRef | Web of Science | Medline10
Gustafsson C ,Britton M . Pathogenetic mechanism of stroke in non-valvular atrial fibrillation: follow-up of stroke patients with and without atrial fibrillation. J Intern Med 1991;230:11-16
CrossRef | Web of Science | Medline11
Kaarisalo MM ,Immonen-Raiha P ,Marttila RJ , et al. Atrial fibrillation and stroke: mortality and causes of death after the first acute ischemic stroke. Stroke 1997;28:311-315
CrossRef | Web of Science | Medline12
Penado S ,Cano M ,Acha O ,Hernandez JL ,Riancho JA . Stroke severity in patients with atrial fibrillation. Am J Med 2002;112:572-574
CrossRef | Web of Science | Medline13
Lamassa M ,Di Carlo A ,Pracucci G , et al. Characteristics, outcome, and care of stroke associated with atrial fibrillation in Europe: data from a multinational hospital-based registry (The European Community Stroke Project). Stroke 2001;32:392-398
CrossRef | Web of Science | Medline14
Candelise L ,Pinardi G ,Morabito A . Mortality in acute stroke with atrial fibrillation. Stroke 1991;22:169-174
CrossRef | Web of Science | Medline15
Lin HJ ,Wolf PA ,Kelly-Hayes M , et al. Stroke severity in atrial fibrillation: the Framingham Study. Stroke 1996;27:1760-1764
CrossRef | Web of Science | Medline16
Risk factors for stroke and efficacy of antithrombotic therapy in atrial fibrillation: analysis of pooled data from five randomized controlled trials. Arch Intern Med 1994;154:1449-1457[Erratum, Arch Intern Med 1994;154:2254.]
CrossRef | Web of Science | Medline17
Hart RG ,Benavente O ,McBride R ,Pearce LA . Antithrombotic therapy to prevent stroke in patients with atrial fibrillation: a meta-analysis. Ann Intern Med 1999;131:492-501
Web of Science | Medline18
Adjusted-dose warfarin versus low-intensity, fixed-dose warfarin plus aspirin for high-risk patients with atrial fibrillation: Stroke Prevention in Atrial Fibrillation III randomised clinical trial. Lancet 1996;348:633-638
CrossRef | Web of Science | Medline19
Hylek EM ,Skates SJ ,Sheehan MA ,Singer DE . An analysis of the lowest effective intensity of prophylactic anticoagulation for patients with nonrheumatic atrial fibrillation. N Engl J Med 1996;335:540-546
Full Text | Web of Science | Medline20
van Walraven C ,Hart RG ,Singer DE , et al. Oral anticoagulants vs aspirin in nonvalvular atrial fibrillation: an individual patient meta-analysis. JAMA 2002;288:2441-2448
CrossRef | Web of Science | Medline21
Go AS ,Hylek EM ,Borowsky LH ,Phillips KA ,Selby JV ,Singer DE . Warfarin use among ambulatory patients with nonvalvular atrial fibrillation: the anticoagulation and risk factors in atrial fibrillation (ATRIA) study. Ann Intern Med 1999;131:927-934
Web of Science | Medline22
International classification of diseases, 9th revision, clinical modification (ICD-9-CM). Vol. 1 and 2. Dover, Del.: American Medical Association, 1999.
23
Bamford J ,Sandercock P ,Dennis M ,Burn J ,Warlow C . A prospective study of acute cerebrovascular disease in the community: the Oxfordshire Community Stroke Project -- 1981-1986. 2. Incidence, case fatality rates and overall outcome at one year of cerebral infarction, primary intracerebral and subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry 1990;53:16-22
CrossRef | Web of Science | Medline24
Arellano MG ,Petersen GR ,Petitti DB ,Smith RE . The California Automated Mortality Linkage System (CAMLIS). Am J Public Health 1984;74:1324-1330
CrossRef | Web of Science | Medline25
Go AS ,Hylek EM ,Phillips KA , et al. Effectiveness and safety of warfarin to prevent thromboembolism among 13,559 patients with atrial fibrillation: how well do results of randomized trials apply to clinical practice? The ATRIA Study. Circulation 2002;106:Suppl II:II-515 abstract.26
Rosendaal FR ,Cannegieter SC ,van der Meer FJ ,Briet E . A method to determine the optimal intensity of oral anticoagulant therapy. Thromb Haemost 1993;69:236-239
Web of Science | Medline27
Mantel N . Chi-square tests with one degree of freedom: extensions of the Mantel-Haenszel procedure. J Am Stat Assoc 1963;58:690-700
CrossRef | Web of Science28
McCullagh P . Regression models for ordinal data. J Stat Soc [B] 1980;42:109-14229
Kalbfleisch JD, Prentice RL. The statistical analysis of failure time data. New York: John Wiley, 1980.
30
Eckman MH ,Falk RH ,Pauker SG . Cost-effectiveness of therapies for patients with nonvalvular atrial fibrillation. Arch Intern Med 1998;158:1669-1677
CrossRef | Web of Science | Medline31
Gage BF ,Cardinalli AB ,Albers GW ,Owens DK . Cost-effectiveness of warfarin and aspirin for prophylaxis of stroke in patients with nonvalvular atrial fibrillation. JAMA 1995;274:1839-1845
CrossRef | Web of Science | Medline32
Thomson R ,Parkin D ,Eccles M ,Sudlow M ,Robinson A . Decision analysis and guidelines for anticoagulant therapy to prevent stroke in patients with atrial fibrillation. Lancet 2000;355:956-962[Erratum, Lancet 2000;355:1466.]
CrossRef | Web of Science | Medline33
Man-Son-Hing M ,Nichol G ,Lau A ,Laupacis A . Choosing antithrombotic therapy for elderly patients with atrial fibrillation who are at risk for falls. Arch Intern Med 1999;159:677-685
CrossRef | Web of Science | Medline34
Albers GW ,Dalen JE ,Laupacis A ,Manning WJ ,Petersen P ,Singer DE . Antithrombotic therapy in atrial fibrillation. Chest 2001;119:Suppl:194S-206S
CrossRef | Web of Science | Medline35
Fuster V ,Ryden LE ,Asinger RW , et al. ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to Develop Guidelines for the Management of Patients with Atrial Fibrillation) developed in collaboration with the North American Society of Pacing and Electrophysiology. Circulation 2001;104:2118-2150
Web of Science | Medline36
Gage BF ,Cardinalli AB ,Owens DK . The effect of stroke and stroke prophylaxis with aspirin or warfarin on quality of life. Arch Intern Med 1996;156:1829-1836
CrossRef | Web of Science | Medline37
Hylek EM ,Singer DE . Risk factors for intracranial hemorrhage in outpatients taking warfarin. Ann Intern Med 1994;120:897-902
Web of Science | Medline38
The Stroke Prevention in Atrial Fibrillation Investigators
CrossRef | Web of Science | Medline39
Landefeld CS ,Goldman L . Major bleeding in outpatients treated with warfarin: incidence and prediction by factors known at the start of outpatient therapy. Am J Med 1989;87:144-152
CrossRef | Web of Science | Medline40
van der Meer FJ ,Rosendaal FR ,Vandenbroucke JP ,Briet E . Bleeding complications in oral anticoagulant therapy: an analysis of risk factors. Arch Intern Med 1993;153:1557-1562
CrossRef | Web of Science | Medline41
Palareti G ,Leali N ,Coccheri S , et al. Bleeding complications of oral anticoagulant treatment: an inception-cohort, prospective collaborative study (ISCOAT). Lancet 1996;348:423-428
CrossRef | Web of Science | Medline42
Evans A ,Kalra L . Are the results of randomized controlled trials on anticoagulation in patients with atrial fibrillation generalizable to clinical practice? Arch Intern Med 2001;161:1443-1447
CrossRef | Web of Science | Medline43
Miettinen OS . The need for randomization in the study of intended effects. Stat Med 1983;2:267-271
CrossRef | Medline
- Citing Articles (234)
Citing Articles
1
Takeshi Omae, Yuichi Kanmura. (2012) Management of postoperative atrial fibrillation. Journal of Anesthesia
CrossRef2
James B Wetmore, Jonathan D Mahnken, Sally K Rigler, Edward F Ellerbeck, Purna Mukhopadhyay, John A Spertus, Qingjiang Hou, Theresa I Shireman. (2011) The prevalence of and factors associated with chronic atrial fibrillation in Medicare/Medicaid-eligible dialysis patients. Kidney International
CrossRef3
Karl Georg Haeusler, Maria Konieczny, Matthias Endres, Arno Villringer, Peter U. Heuschmann. (2011) Impact of anticoagulation before stroke on stroke severity and long-term survival. International Journal of Stroken/a-n/a
CrossRef4
Candice L Garwood, Jamie M Hwang, Lynette R Moser. (2011) Striking a Balance Between the Risks and Benefits of Anticoagulation Bridge Therapy in Patients with Atrial Fibrillation: Clinical Updates and Remaining Controversies. Pharmacotherapy 31:12, 1208-1220
CrossRef5
Larisa H Cavallari, Jaekyu Shin, Minoli A Perera. (2011) Role of Pharmacogenomics in the Management of Traditional and Novel Oral Anticoagulants. Pharmacotherapy 31:12, 1192-1207
CrossRef6
Miyoko Naganuma, Tsuyoshi Shiga, Kumi Sato, Kagari Murasaki, Masayuki Hashiguchi, Mayumi Mochizuki, Nobuhisa Hagiwara. (2011) Clinical outcome in Japanese elderly patients with non-valvular atrial fibrillation taking warfarin: A single-center observational study. Thrombosis Research
CrossRef7
Susana P.D. Sá, Rui P. Rodrigues, João Santos-Antunes, Francisco Rocha Gonçalves, José Pedro L. Nunes. (2011) Antithrombotic therapy in nonvalvular atrial fibrillation: A narrative review. Revista Portuguesa de Cardiologia (English Edition) 30:12, 905-924
CrossRef8
Ilyas Mohammed, Adam Mohmand-Borkowski, James F. Burke, Peter R. Kowey. (2011) Stroke prevention in atrial fibrillation. Journal of Cardiovascular Medicine1
CrossRef9
Larisa H. Cavallari, Minoli Perera, Mia Wadelius, Panos Deloukas, Gelson Taube, Shitalben R. Patel, Keston Aquino-Michaels, Marlos A.G. Viana, Nancy L. Shapiro, Edith A. Nutescu. (2011) Association of the GGCX (CAA)16/17 repeat polymorphism with higher warfarin dose requirements in African Americans. Pharmacogenetics and Genomics1
CrossRef10
Sana M. Al-Khatib, John H. Alexander, Renato D. Lopes, Kenneth W. Mahaffey, Manesh R. Patel, Christopher B. Granger. (2011) Promise of Factor Xa Inhibition in Atrial Fibrillation. Current Cardiology Reports
CrossRef11
Cooper, William O., Habel, Laurel A., Sox, Colin M., Chan, K. Arnold, Arbogast, Patrick G., Cheetham, T. Craig, Murray, Katherine T., Quinn, Virginia P., Stein, C. Michael, Callahan, S. Todd, Fireman, Bruce H., Fish, Frank A., Kirshner, Howard S., O'Duffy, Anne, Connell, Frederick A., Ray, Wayne A., . (2011) ADHD Drugs and Serious Cardiovascular Events in Children and Young Adults. New England Journal of Medicine 365:20, 1896-1904
Full Text12
Tammy J. Bungard, Claudia Bucci, Heather Kertland, Kori Leblanc, Jennifer Pickering, William M. Semchuk. (2011) A systematic approach to stroke prevention for patients with atrial fibrillation. Canadian Pharmacists Journal 144:6, 287-394
CrossRef13
Jérôme Thireau, Jean-Luc Pasquié, Eric Martel, Jean-Yves Le Guennec, Sylvain Richard. (2011) New drugs vs. old concepts: A fresh look at antiarrhythmics. Pharmacology & Therapeutics 132:2, 125-145
CrossRef14
Yvonne Schwammenthal, Nathan M. Bornstein, Uri Goldbourt, Silvia Koton, Roseline Schwartz, Nina Koren-Morag, Ehud Grossman, David Tanne. (2011) Anticoagulation remains underused in prevention of stroke associated with atrial fibrillation: Insights from two consecutive national surveys. International Journal of Cardiology 152:3, 356-361
CrossRef15
Susana P.D. Sá, Rui P. Rodrigues, João Santos-Antunes, Francisco Rocha Gonçalves, José Pedro L. Nunes. (2011) Antithrombotic therapy in nonvalvular atrial fibrillation: A narrative review. Revista Portuguesa de Cardiologia
CrossRef16
Eva Giralt-Steinhauer, Elisa Cuadrado-Godia, Ángel Ois, Jordi Jiménez-Conde, Ana Rodríguez-Campello, Lluis Planellas, Sara Jimena-García, Miguel Ángel Rubio, Jaume Roquer-González. (2011) CHA2DS2-VASc score and prognosis in ischemic strokes with atrial fibrillation. Journal of Neurology
CrossRef17
Daniel Caldeira, Cláudio David, Cristina Sampaio. (2011) Rate vs rhythm control in patients with atrial fibrillation and heart failure: A systematic review and meta-analysis of randomised controlled trials. European Journal of Internal Medicine 22:5, 448-455
CrossRef18
P. R. Sinnaeve, M. Brueckmann, A. Clemens, J. Oldgren, J. Eikelboom, J. S. Healey. (2011) Stroke prevention in elderly patients with atrial fibrillation: challenges for anticoagulation. Journal of Internal Medicineno-no
CrossRef19
ROGER A. WINKLE, R. HARDWIN MEAD, GREGORY ENGEL, MELISSA H. KONG, ROB A. PATRAWALA. (2011) The Use of Dabigatran Immediately After Atrial Fibrillation Ablation. Journal of Cardiovascular Electrophysiologyno-no
CrossRef20
F. D. R. Hobbs, I. Leach. (2011) Challenges of stroke prevention in patients with atrial fibrillation in clinical practice. QJM 104:9, 739-746
CrossRef21
K. M. SHERMOCK, M. B. STREIFF, B. L. PINTO, P. KRAUS, P. J. PRONOVOST. (2011) Novel analysis of clinically relevant diagnostic errors in point-of-care devices. Journal of Thrombosis and Haemostasis 9:9, 1769-1775
CrossRef22
MYUNG-JIN CHA, GYU-CHUL OH, SEOKYUNG HAHN, EUE-KEUN CHOI, SEIL OH. (2011) Thromboembolic Risk Evaluation in Patients with Atrial Fibrillation Using a Modified CHADS2 Scoring System. Journal of Cardiovascular Electrophysiologyno-no
CrossRef23
Allison Burnett, Jason Cohen, David A. Garcia. 2011. Hemorrhagic Complications of Anticoagulants in Hospitalized Patients. , 291-330.
CrossRef24
A. John Camm, Henri Bounameaux. (2011) Edoxaban. Drugs 71:12, 1503-1526
CrossRef25
P. Kirchhof, G. Y. H. Lip, I. C. Van Gelder, J. Bax, E. Hylek, S. Kaab, U. Schotten, K. Wegscheider, G. Boriani, A. Brandes, M. Ezekowitz, H. Diener, L. Haegeli, H. Heidbuchel, D. Lane, L. Mont, S. Willems, P. Dorian, M. Aunes-Jansson, C. Blomstrom-Lundqvist, M. Borentain, S. Breitenstein, M. Brueckmann, N. Cater, A. Clemens, D. Dobrev, S. Dubner, N. G. Edvardsson, L. Friberg, A. Goette, M. Gulizia, R. Hatala, J. Horwood, L. Szumowski, L. Kappenberger, J. Kautzner, A. Leute, T. Lobban, R. Meyer, J. Millerhagen, J. Morgan, F. Muenzel, M. Nabauer, C. Baertels, M. Oeff, D. Paar, J. Polifka, U. Ravens, L. Rosin, W. Stegink, G. Steinbeck, P. Vardas, A. Vincent, M. Walter, G. Breithardt, A. J. Camm. (2011) Comprehensive risk reduction in patients with atrial fibrillation: emerging diagnostic and therapeutic options--a report from the 3rd Atrial Fibrillation Competence NETwork/European Heart Rhythm Association consensus conference. Europace
CrossRef26
Ramon A Partida, Robert P Giugliano. (2011) Edoxaban: pharmacological principles, preclinical and early-phase clinical testing. Future Cardiology 7:4, 459-470
CrossRef27
Michael D. Ezekowitz, Rangadham Nagarakanti. (2011) Dabigatran in atrial fibrillation: pharmacology and clinical trials. Journal of Interventional Cardiac Electrophysiology
CrossRef28
E. Pautas, I. Peyron, N. Mitha, V. Siguret, I. Gouin-Thibault. (2011) Gestion des accidents des anticoagulants chez le sujet âgé en médecine d’urgence. Les cahiers de l'année gérontologique 3:2, 83-89
CrossRef29
Laurent M Haegeli, Firat Duru. (2011) Atrial fibrillation in the aging heart: pharmacological therapy and catheter ablation in the elderly. Future Cardiology 7:3, 415-423
CrossRef30
L Y Ho, C W Siu, W S Yue, C P Lau, G Y Lip, H F Tse. (2011) Safety and efficacy of oral anticoagulation therapy in Chinese patients with concomitant atrial fibrillation and hypertension. Journal of Human Hypertension 25:5, 304-310
CrossRef31
Gwendolyn A McMillin, Sara R Vazquez, Robert C Pendleton. (2011) Current challenges in personalizing warfarin therapy. Expert Review of Clinical Pharmacology 4:3, 349-362
CrossRef32
MING LIM. (2011) Treating inflammation in childhood neurodegenerative disorders. Developmental Medicine & Child Neurology 53:4, 298-304
CrossRef33
K. P. CABRAL, J. ANSELL, E. M. HYLEK. (2011) Future directions of stroke prevention in atrial fibrillation: the potential impact of novel anticoagulants and stroke risk stratification. Journal of Thrombosis and Haemostasis 9:3, 441-449
CrossRef34
J.M. Calvo Romero. (2011) ¿Dabigatrán o antagonistas de la vitamina K en la prevención de ictus en pacientes con fibrilación auricular?. Revista Clínica Española 211:3, 142-146
CrossRef35
R. Veltkamp, W. Hacke. (2011) Neue orale Antikoagulanzien beim Vorhofflimmern. Der Nervenarzt 82:2, 180-189
CrossRef36
Matthew B. Sellers, L. Kristin Newby. (2011) Atrial fibrillation, anticoagulation, fall risk, and outcomes in elderly patients. American Heart Journal 161:2, 241-246
CrossRef37
P. Kirchhof, M. Nabauer, A. Gerth, T. Limbourg, T. Lewalter, A. Goette, K. Wegscheider, A. Treszl, T. Meinertz, M. Oeff, U. Ravens, G. Breithardt, G. Steinbeck, . (2011) Impact of the type of centre on management of AF patients: Surprising evidence for differences in antithrombotic therapy decisions. Thrombosis and Haemostasis 105:6, 1010-1023
CrossRef38
G. Palareti. (2011) Bleeding with anticoagulant treatments. Hämostaseologie 31:4, 237-242
CrossRef39
S. V. Sorensen, A. R. Kansal, S. Connolly, S. Peng, J. Linnehan, C. Bradley-Kennedy, J. M. Plumb. (2011) Cost-effectiveness of dabigatran etexilate for the prevention of stroke and systemic embolism in atrial fibrillation:A Canadian payer perspective. Thrombosis and Haemostasis 105:5, 908-919
CrossRef40
Laurent M. Haegeli, Firat Duru. (2011) Management of Patients with Atrial Fibrillation: Specific Considerations for the Old Age. Cardiology Research and Practice 2011, 1-8
CrossRef41
I. M. Ogilvie, S. A. Welner, W. Cowell, G. Y. H. Lip. (2011) Ischaemic stroke and bleeding rates in ‘real-world’ atrial fibrillation patients. Thrombosis and Haemostasis 106:1, 34-44
CrossRef42
J. B. Olesen, G. Y. H. Lip, J. Lindhardsen, D. A. Lane, O. Ahlehoff, M. L. Hansen, J. Raunsø, J. S. Tolstrup, P. R. Hansen, G. H. Gislason, C. Torp-Pedersen. (2011) Risks of thromboembolism and bleeding with thromboprophylaxis in patients with atrial fibrillation: A net clinical benefit analysis using a ‘real world’ nationwide cohort study. Thrombosis and Haemostasis 106:4, 739-749
CrossRef43
Ken Okumura, Takashi Komatsu, Takeshi Yamashita, Yuji Okuyama, Masahiko Harada, Yoshiyuki Konta, Toru Hatayama, Daisuke Horiuchi, Eiki Tsushima. (2011) Time in the Therapeutic Range During Warfarin Therapy in Japanese Patients With Non-Valvular Atrial Fibrillation. Circulation Journal 75:9, 2087-2094
CrossRef44
Mari Matsumoto, Shuhei Okazaki, Manabu Sakaguchi, Nobuyuki Ohara, Shigetaka Furukado, Keiko Nagano, Yasuyuki Kuwagata, Takeshi Shimazu, Toshiki Yoshimine, Kazuo Kitagawa. (2011) Preadmission Therapeutic Anticoagulation Reduces Cerebral Infarct Volume in Patients with Nonvalvular Atrial Fibrillation. European Neurology 66:5, 277-282
CrossRef45
A. M. Gallagher, E. Setakis, J. M. Plumb, A. Clemens, T.-P. van Staa. (2011) Risks of stroke and mortality associated with suboptimal anticoagulation in atrial fibrillation patients. Thrombosis and Haemostasis 106:5, 968-977
CrossRef46
F. Dentali, M. Gianni, A. Squizzato, W. Ageno, L. Castiglioni, L. Maroni, E. M. Hylek, A. M. Grandi, E. Cazzani, A. Venco, L. Guasti. (2011) Use of statins and recurrence of atrial fibrillation after catheter ablation or electrical cardioversion. Thrombosis and Haemostasis 106:2, 363-370
CrossRef47
M. Àngels Font, Jerzy Krupinski, Adrià Arboix. (2011) Antithrombotic Medication for Cardioembolic Stroke Prevention. Stroke Research and Treatment 2011, 1-23
CrossRef48
Archit Bhatt, Arshad Majid, Anmar Razak, Mounzer Kassab, Syed Hussain, Adnan Safdar. (2011) Predictors of Occult Paroxysmal Atrial Fibrillation in Cryptogenic Strokes Detected by Long-Term Noninvasive Cardiac Monitoring. Stroke Research and Treatment 2011, 1-5
CrossRef49
Selvakumar Velu, Gregory YH Lip. (2011) Recent Progress in Antithrombotic Therapy for Atrial Fibrillation. Journal of Atherosclerosis and Thrombosis 18:4, 257-273
CrossRef50
Kensaku Shibazaki, Kazumi Kimura, Yasuyuki Iguchi, Junya Aoki, Kenichiro Sakai, Kazuto Kobayashi. (2011) Differences in Brain Natriuretic Peptide Value between Transient Ischemic Attack and Stroke Patients with Atrial Fibrillation. European Neurology 66:5, 271-276
CrossRef51
Hiroyuki Iwahana, Shizukiyo Ishikawa, Joji Ishikawa, Tomoyuki Kabutoya, Kazunori Kayaba, Tadao Gotoh, Eiji Kajii. (2011) Atrial Fibrillation Is a Major Risk Factor for Stroke, Especially in Women: The Jichi Medical School Cohort Study. Journal of Epidemiology 21:2, 95-101
CrossRef52
Tatjana S. Potpara, Gregory Y.H. Lip. (2011) Ischemic Stroke and Atrial Fibrillation – A DeadlySerious Combination. Cerebrovascular Diseases 32:5, 461-462
CrossRef53
J-RHYTHM Registry Investigators. (2011) Determinants of Warfarin Use and International Normalized Ratio Levels in Atrial Fibrillation Patients in Japan. Circulation Journal 75:10, 2357-2362
CrossRef54
Raul Altman, Hector O Vidal. (2011) Battle of oral anticoagulants in the field of atrial fibrillation scrutinized from a clinical practice (the real world) perspective. Thrombosis Journal 9:1, 12
CrossRef55
S. Jamil-Copley, P. Kanagaratnam. (2010) Stroke in atrial fibrillation--hope on the horizon?. Journal of The Royal Society Interface 7:Suppl_6, S765-S769
CrossRef56
B. Leithäuser, F. Kasch, T. Broemel, J.-W. Park. (2010) Persistierender linksatrialer Thrombus bei Vorhofflimmern unter oraler Antikoagulation. Herz 35:8, 576-581
CrossRef57
F. Yang, D. Chou, P. Schweitzer, S. Hanon. (2010) Warfarin in haemodialysis patients with atrial fibrillation: what benefit?. Europace 12:12, 1666-1672
CrossRef58
Stephan H. Schirmer, Magnus Baumhäkel, Hans-Ruprecht Neuberger, Stefan H. Hohnloser, Isabelle C. van Gelder, Gregory Y.H. Lip, Michael Böhm. (2010) Novel Anticoagulants for Stroke Prevention in Atrial Fibrillation. Journal of the American College of Cardiology 56:25, 2067-2076
CrossRef59
L.V. Andersen, L.S. Mortensen, J.S. Lindholt, O. Faergeman, E.W. Henneberg, L. Frost. (2010) Upper-Limb Thrombo-Embolectomy: National Cohort Study in Denmark. European Journal of Vascular and Endovascular Surgery 40:5, 628-634
CrossRef60
Jonathan Mant, Duncan Edwards. (2010) Stroke Prevention in Atrial Fibrillation. Drugs & Aging 27:11, 859-870
CrossRef61
, , , A. J. Camm, P. Kirchhof, G. Y. H. Lip, U. Schotten, I. Savelieva, S. Ernst, I. C. Van Gelder, N. Al-Attar, G. Hindricks, B. Prendergast, H. Heidbuchel, O. Alfieri, A. Angelini, D. Atar, P. Colonna, R. De Caterina, J. De Sutter, A. Goette, B. Gorenek, M. Heldal, S. H. Hohloser, P. Kolh, J.-Y. Le Heuzey, P. Ponikowski, F. H. Rutten, , A. Vahanian, A. Auricchio, J. Bax, C. Ceconi, V. Dean, G. Filippatos, C. Funck-Brentano, R. Hobbs, P. Kearney, T. McDonagh, B. A. Popescu, Z. Reiner, U. Sechtem, P. A. Sirnes, M. Tendera, P. E. Vardas, P. Widimsky, , P. E. Vardas, V. Agladze, E. Aliot, T. Balabanski, C. Blomstrom-Lundqvist, A. Capucci, H. Crijns, B. Dahlof, T. Folliguet, M. Glikson, M. Goethals, D. C. Gulba, S. Y. Ho, R. J. M. Klautz, S. Kose, J. McMurray, P. Perrone Filardi, P. Raatikainen, M. J. Salvador, M. J. Schalij, A. Shpektor, J. Sousa, J. Stepinska, H. Uuetoa, J. L. Zamorano, I. Zupan. (2010) Guidelines for the management of atrial fibrillation: The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Europace 12:10, 1360-1420
CrossRef62
, , , A. J. Camm, P. Kirchhof, G. Y. H. Lip, U. Schotten, I. Savelieva, S. Ernst, I. C. Van Gelder, N. Al-Attar, G. Hindricks, B. Prendergast, H. Heidbuchel, O. Alfieri, A. Angelini, D. Atar, P. Colonna, R. De Caterina, J. De Sutter, A. Goette, B. Gorenek, M. Heldal, S. H. Hohloser, P. Kolh, J.-Y. Le Heuzey, P. Ponikowski, F. H. Rutten, , A. Vahanian, A. Auricchio, J. Bax, C. Ceconi, V. Dean, G. Filippatos, C. Funck-Brentano, R. Hobbs, P. Kearney, T. McDonagh, B. A. Popescu, Z. Reiner, U. Sechtem, P. A. Sirnes, M. Tendera, P. E. Vardas, P. Widimsky, , P. E. Vardas, V. Agladze, E. Aliot, T. Balabanski, C. Blomstrom-Lundqvist, A. Capucci, H. Crijns, B. Dahlof, T. Folliguet, M. Glikson, M. Goethals, D. C. Gulba, S. Y. Ho, R. J. M. Klautz, S. Kose, J. McMurray, P. Perrone Filardi, P. Raatikainen, M. J. Salvador, M. J. Schalij, A. Shpektor, J. Sousa, J. Stepinska, H. Uuetoa, J. L. Zamorano, I. Zupan. (2010) Guidelines for the management of atrial fibrillation: The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). European Heart Journal 31:19, 2369-2429
CrossRef63
Haruhiko Hoshino, Yoshiaki Itoh, Hiroaki Kimura, Koichi Miyaki, Norihiro Suzuki. (2010) Prestroke Anticoagulation and Paroxysmal Type Are Correlated With Favorable Outcome in Ischemic Stroke Patients With Atrial Fibrillation. Journal of Stroke and Cerebrovascular Diseases
CrossRef64
Hans VonMarensdorf, Tarek M. Elghetany, John R. Petersen. (2010) Authors reply to “Assessment of agreement between INR measures must correspond to a clinical reality”. Clinica Chimica Acta 411:17-18, 1386-1387
CrossRef65
Gilles Pernod, Anne Godiér, Claire Gozalo, Benjamin Tremey, Pierre Sié. (2010) French clinical practice guidelines on the management of patients on vitamin K antagonists in at-risk situations (overdose, risk of bleeding, and active bleeding). Thrombosis Research 126:3, e167-e174
CrossRef66
R. De Caterina, S. J. Connolly, J. Pogue, S. Chrolavicius, A. Budaj, J. Morais, G. Renda, S. Yusuf, . (2010) Mortality predictors and effects of antithrombotic therapies in atrial fibrillation: insights from ACTIVE-W. European Heart Journal 31:17, 2133-2140
CrossRef67
Lars Wallentin, Salim Yusuf, Michael D Ezekowitz, Marco Alings, Marcus Flather, Maria Grazia Franzosi, Prem Pais, Antonio Dans, John Eikelboom, Jonas Oldgren, Janice Pogue, Paul A Reilly, Sean Yang, Stuart J Connolly. (2010) Efficacy and safety of dabigatran compared with warfarin at different levels of international normalised ratio control for stroke prevention in atrial fibrillation: an analysis of the RE-LY trial. The Lancet 376:9745, 975-983
CrossRef68
Stéphane Ederhy, Ghislaine Dufaitre, Louise Boyer-Chatenet, Catherine Meuleman, Emanuele Di Angelantonio, Sylvie Lang, Franck Boccara, Ariel Cohen. (2010) Should all patients with non-valvular atrial fibrillation be anticoagulated?. International Journal of Cardiology 143:1, 8-15
CrossRef69
Dmitry A. Zateyshchikov, Alexey N. Brovkin, Dimitry A. Chistiakov, Valery V. Nosikov. (2010) Advanced age, low left atrial appendage velocity, and Factor V promoter sequence variation as predictors of left atrial thrombosis in patients with nonvalvular atrial fibrillation. Journal of Thrombosis and Thrombolysis 30:2, 192-199
CrossRef70
Michele Torella, Daniele Torella, Paolo Chiodini, Marco Franciulli, Giampaolo Romano, Luca De Santo, Marisa De Feo, Cristiano Amarelli, Ferdinando C. Sasso, Teresa Salvatore, Georgina M. Ellison, Ciro Indolfi, Maurizio Cotrufo, Gianantonio Nappi. (2010) LOWERing the INtensity of oral anticoaGulant Therapy in patients with bileaflet mechanical aortic valve replacement: Results from the “LOWERING-IT” Trial. American Heart Journal 160:1, 171-178
CrossRef71
G. W. J. HAWRYLUK, J. W. AUSTIN, J. C. FURLAN, J. B. LEE, C. O'KELLY, M. G. FEHLINGS. (2010) Management of anticoagulation following central nervous system hemorrhage in patients with high thromboembolic risk. Journal of Thrombosis and Haemostasis 8:7, 1500-1508
CrossRef72
Isla M. Ogilvie, Nick Newton, Sharon A. Welner, Warren Cowell, Gregory Y.H. Lip. (2010) Underuse of Oral Anticoagulants in Atrial Fibrillation: A Systematic Review. The American Journal of Medicine 123:7, 638-645.e4
CrossRef73
Pamala Kanagasabapathy, Pratima Chowdary, Alex Gatt. (2010) Alternatives to Warfarin-The Next Generation of Anticoagulants. Cardiovascular Therapeuticsno-no
CrossRef74
R. Pisters, R. J. van Oostenbrugge, I. L. H. Knottnerus, C. B. de Vos, A. Boreas, J. Lodder, M. H. Prins, H. J. G. M. Crijns, R. G. Tieleman. (2010) The likelihood of decreasing strokes in atrial fibrillation patients by strict application of guidelines. Europace 12:6, 779-784
CrossRef75
BYUNG HO LEE, JAE SEOK PARK, JAE HYUNG PARK, JONG SEUNG PARK, JAE JIN KWAK, EUI SEOCK HWANG, SOOK KYOUNG KIM, DONG HOON CHOI, YOUNG-HOON KIM, HUI-NAM PAK. (2010) The Effect and Safety of the Antithrombotic Therapies in Patients with Atrial Fibrillation and CHADS 2 Score 1. Journal of Cardiovascular Electrophysiology 21:5, 501-507
CrossRef76
Eva K. Rombouts, Frits R. Rosendaal, Felix J. M. Van Der Meer. (2010) Influence of dietary vitamin K intake on subtherapeutic oral anticoagulant therapy. British Journal of Haematology 149:4, 598-605
CrossRef77
D. M. WITT, T. DELATE, N. P. CLARK, C. MARTELL, T. TRAN, M. A. CROWTHER, D. A. GARCIA, W. AGENO, E. M. HYLEK, . (2010) Twelve-month outcomes and predictors of very stable INR control in prevalent warfarin users. Journal of Thrombosis and Haemostasis 8:4, 744-749
CrossRef78
Freek W. A. Verheugt. (2010) Novel oral anticoagulants to prevent stroke in atrial fibrillation. Nature Reviews Cardiology 7:3, 149-154
CrossRef79
Yvonne Schwammenthal, Natan Bornstein, Ehud Schwammenthal, Roseline Schwartz, Uri Goldbourt, Rakefet Tsabari, Silvia Koton, Ehud Grossman, David Tanne. (2010) Relation of Effective Anticoagulation in Patients With Atrial Fibrillation to Stroke Severity and Survival (from the National Acute Stroke Israeli Survey [NASIS]). The American Journal of Cardiology 105:3, 411-416
CrossRef80
Roger E. Kelley. (2010) Neurologic Presentations of Cardiac Disease. Neurologic Clinics 28:1, 17-36
CrossRef81
Yasuteru Inoue, Yuichiro Inatomi, Toshiro Yonehara, Yoichiro Hashimoto, Teruyuki Hirano, Makoto Uchino. (2010) Ischemic stroke under anticoagulant therapy. Rinsho Shinkeigaku 50:7, 455-460
CrossRef82
G. Y.H. Lip, L. H. Rasmussen, S. B. Olsson, E. C. Jensen, A. L. Persson, U. Eriksson, K. F.C. Wahlander, . (2009) Oral direct thrombin inhibitor AZD0837 for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation: a randomized dose-guiding, safety, and tolerability study of four doses of AZD0837 vs. vitamin K antagonists. European Heart Journal 30:23, 2897-2907
CrossRef83
Daniel Kurnik, Ronen Loebstein, Hillel Halkin, Eva Gak, Shlomo Almog. (2009) 10 years of oral anticoagulant pharmacogenomics: what difference will it make? A critical appraisal. Pharmacogenomics 10:12, 1955-1965
CrossRef84
Carl van Walraven, Natalie Oake, Doug Coyle, Monica Taljaard, Alan J. Forster. (2009) Changes in surrogate outcomes can be translated into clinical outcomes using a Monte Carlo model. Journal of Clinical Epidemiology 62:12, 1306-1315
CrossRef85
J H S You, K K N Tsui, R S M Wong, G Cheng. (2009) Potential Clinical and Economic Outcomes of CYP2C9 and VKORC1 Genotype-Guided Dosing in Patients Starting Warfarin Therapy. Clinical Pharmacology & Therapeutics 86:5, 540-547
CrossRef86
D. Werner, U. Werner, A. Wuerfel, A. Grosch, H. G. Lestin, T. Eschenhagen, T. Rau. (2009) Pharmacogenetic characteristics of patients with complicated phenprocoumon dosing. European Journal of Clinical Pharmacology 65:8, 783-788
CrossRef87
N.A. Limdi, H. Wiener, J.A. Goldstein, R.T. Acton, T.M. Beasley. (2009) Influence of CYP2C9 and VKORC1 on warfarin response during initiation of therapy. Blood Cells, Molecules, and Diseases 43:1, 119-128
CrossRef88
Mark A. Crandall, David J. Bradley, Douglas L. Packer, Samuel J. Asirvatham. (2009) Contemporary Management of Atrial Fibrillation: Update on Anticoagulation and Invasive Management Strategies. Mayo Clinic Proceedings 84:7, 643-662
CrossRef89
M. A. Crandall, D. J. Bradley, D. L. Packer, S. J. Asirvatham. (2009) Contemporary Management of Atrial Fibrillation: Update on Anticoagulation and Invasive Management Strategies. Mayo Clinic Proceedings 84:7, 643-662
CrossRef90
Timothy J Kleinig, Robert Vink. (2009) Suppression of inflammation in ischemic and hemorrhagic stroke: therapeutic options. Current Opinion in Neurology 22:3, 294-301
CrossRef91
Sonja V. Sorensen, Sarah Dewilde, Daniel E. Singer, Samuel Z. Goldhaber, Brigitta U. Monz, Jonathan M. Plumb. (2009) Cost-effectiveness of warfarin: Trial versus “real-world” stroke prevention in atrial fibrillation. American Heart Journal 157:6, 1064-1073
CrossRef92
Melkon Hacobian, Samuel Z. Goldhaber. 2009. Pharmacogenomics and Warfarin Anticoagulation. , 37-48.
CrossRef93
J. Staszewski, B. Brodacki, K. Tomczykiewicz, J. Kotowicz, A. Stepien. (2009) Strokes in paroxysmal atrial fibrillation have more favorable outcome than in permanent atrial fibrillation. Acta Neurologica Scandinavica 119:5, 325-331
CrossRef94
Larisa H. Cavallari, Jonathan L. Aston, Kathryn M. Momary, Nancy L. Shapiro, Shitalben R. Patel, Edith A. Nutescu. (2009) Predictors of unstable anticoagulation in African Americans. Journal of Thrombosis and Thrombolysis 27:4, 430-437
CrossRef95
Geno J. Merli, George Tzanis. (2009) Warfarin: what are the clinical implications of an out-of-range-therapeutic international normalized ratio?. Journal of Thrombosis and Thrombolysis 27:3, 293-299
CrossRef96
Johanna H. H. Geest-Daalderop, Barbara A. Hutten, Nathalie C. V. Péquériaux, Marcel Levi, Augueste Sturk. (2009) Improvement in the regulation of the vitamin K antagonist acenocoumarol after a standard initial dose regimen: prospective validation of a prescription model. Journal of Thrombosis and Thrombolysis 27:2, 207-214
CrossRef97
Daniela Poli, Emilia Antonucci, Rossella Marcucci, Lucia Mannini, Michela Falciani, Rosanna Abbate, Gian Franco Gensini, Domenico Prisco. (2009) The quality of anticoagulation on functional outcome and mortality for TIA/stroke in atrial fibrillation patients. International Journal of Cardiology 132:1, 109-113
CrossRef98
Cheryl D. Bushnell, Cathleen S. Colón-Emeric. (2009) Secondary Stroke Prevention Strategies for the Oldest Patients. Drugs & Aging 26:3, 209-230
CrossRef99
Ziad F. Issa, John M. Miller, Douglas P. Zipes. 2009. Atrial Fibrillation. , 208-286.
CrossRef100
Jun Hyung Kim, Young Bin Song, Dae Hee Shin, Je Sang Kim, Jin-Oh Choi, Young Kun On, June Soo Kim. (2009) How Well Does the Target INR Level Maintain in Warfarin-Treated Patients with Non-ValvularAtrial Fibrillation?. Yonsei Medical Journal 50:1, 83
CrossRef101
Boris Leithäuser, Jai-Wun Park. (2009) Cardioembolic Stroke in Atrial Fibrillation-Rationale for Preventive Closure of the Left Atrial Appendage. Korean Circulation Journal 39:11, 443
CrossRef102
Elaine M. Hylek. (2008) Oral anticoagulant therapy for patients with atrial fibrillation - an update. Thrombosis Research 123, S46-S49
CrossRef103
Renato D. Lopes, Jonathan P. Piccini, Elaine M. Hylek, Christopher B. Granger, John H. Alexander. (2008) Antithrombotic therapy in atrial fibrillation: guidelines translated for the clinician. Journal of Thrombosis and Thrombolysis 26:3, 167-174
CrossRef104
Hakan Ay, Ethem Murat Arsava, Levent Gungor, David Greer, Aneesh B. Singhal, Karen L. Furie, Walter J. Koroshetz, A. Gregory Sorensen. (2008) Admission international normalized ratio and acute infarct volume in ischemic stroke. Annals of Neurology 64:5, 499-506
CrossRef105
Elaine M. Hylek, Richard C. Becker. (2008) Atrial fibrillation and stroke severity: Expanding the mechanistic exemplar, clinical phenotype, and goals of anticoagulant pharmacotherapy. Annals of Neurology 64:5, 480-483
CrossRef106
Tatjana Rundek, Ralph L. Sacco. (2008) Risk Factor Management to Prevent First Stroke. Neurologic Clinics 26:4, 1007-1045
CrossRef107
A. J. ROSE, A. OZONOFF, L. E. HENAULT, E. M. HYLEK. (2008) Warfarin for atrial fibrillation in community-based practise. Journal of Thrombosis and Haemostasis 6:10, 1647-1654
CrossRef108
Sumit Verma. (2008) Delivering effective anticoagulation in atrial fibrillation: We can do better!. Heart Rhythm 5:10, 1373-1374
CrossRef109
Oscar M. Jolobe. (2008) INTENSITY OF ANTICOAGULATION IN OCTOGENARIANS WITH NONVALVULAR ATRIAL FIBRILLATION. Journal of the American Geriatrics Society 56:10, 1967-1968
CrossRef110
Nita A Limdi, David L Veenstra. (2008) Warfarin Pharmacogenetics. Pharmacotherapy 28:9, 1084-1097
CrossRef111
Wilbert S. Aronow. (2008) Treatment of Atrial Fibrillation and Atrial Flutter. Cardiology in Review 16:5, 230-239
CrossRef112
Hedi Schelleman, Nita A Limdi, Stephen E Kimmel. (2008) Ethnic differences in warfarin maintenance dose requirement and its relationship with genetics. Pharmacogenomics 9:9, 1331-1346
CrossRef113
Konstantinos Marmagkiolis, Ioannis G. Nikolaidis, Themos Politis, Lawrence Goldstein. (2008) Approach to and management of the acute stroke patient with atrial fibrillation: A literature review. Journal of Hospital Medicine 3:4, 326-332
CrossRef114
Maria I Aguilar, William D Freeman. (2008) Warfarin-related intracerebral hemorrhage: how to proceed. Aging Health 4:3, 299-310
CrossRef115
C. Gandolfo, M. Balestrino, A. Burrone, M. Sette, C. Finocchi. (2008) Stroke due to atrial fibrillation and the attitude to prescribing anticoagulant prevention in Italy.. Journal of Neurology 255:6, 796-802
CrossRef116
Mohamed S Hameed, Anne N Nafziger, Anne M Gartung, Joseph S Bertino. (2008) Pharmacodynamics of Uniform versus Nonuniform Warfarin Dosages. Pharmacotherapy 28:6, 707-711
CrossRef117
Jaspal S. Taggar, Gregory Y. H. Lip. (2008) Anticoagulation in atrial fibrillation: the trials and tribulations of keeping within therapeutic range. Current Medical Research and Opinion 24:5, 1455-1458
CrossRef118
Kevin Jackson, Bernard J. Gersh, Norman Stockbridge, Thomas R. Fleming, Robert Temple, Robert M. Califf, Stuart J. Connolly, Lars Wallentin, Christopher B. Granger. (2008) Antithrombotic drug development for atrial fibrillation: Proceedings, Washington, DC, July 25-27, 2005. American Heart Journal 155:5, 829-840
CrossRef119
Stephen E Kimmel. (2008) Warfarin therapy: in need of improvement after all these years. Expert Opinion on Pharmacotherapy 9:5, 677-686
CrossRef120
Jaspal S Taggar, Gregory YH Lip, Aravinda Nanjundappa, Robert S Dieter, Sangeeta Mandapaka, Pranab Das, Shakeel Ahmad. (2008) Idraparinux for the prevention of thromboembolism in patients with atrial fibrillation. Therapy 5:2, 139-144
CrossRef121
Agustín Urrutia de Diego. (2008) Fibrilación auricular en el anciano. Revista Española de Geriatría y Gerontología 43:2, 106-112
CrossRef122
Lawrence J Lesko, Brian F Gage. (2008) Couma-Gen: implications for future randomized trials of pharmacogenetic-based warfarin therapy. Personalized Medicine 5:2, 163-168
CrossRef123
Y Caraco, S Blotnick, M Muszkat. (2008) CYP2C9 Genotype-guided Warfarin Prescribing Enhances the Efficacy and Safety of Anticoagulation: A Prospective Randomized Controlled Study. Clinical Pharmacology & Therapeutics 83:3, 460-470
CrossRef124
Robert G. Hart, Maria I. Aguilar. (2008) Anticoagulation in atrial fibrillation: selected controversies including optimal anticoagulation intensity, treatment of intracerebral hemorrhage. Journal of Thrombosis and Thrombolysis 25:1, 26-32
CrossRef125
Torsten Becker, Thomas Kleemann, Margit Strauss, Klaus Doenges, Steffen Schneider, Jochen Senges, Karlheinz Seidl. (2008) Long-term prognosis after cardioversion of the first episode of symptomatic atrial fibrillation: a condition believed to be benign revised. Clinical Research in Cardiology 97:2, 74-82
CrossRef126
Wilbert S Aronow, Carmine Sorbera. 2008. Supraventricular Tachyarrhythmias in the Elderly. , 577-604.
CrossRef127
Alan K. Jacobson. (2008) Warfarin monitoring: point-of-care INR testing limitations and interpretation of the prothrombin time. Journal of Thrombosis and Thrombolysis 25:1, 10-11
CrossRef128
Scott Kaatz. (2008) Determinants and measures of quality in oral anticoagulation therapy. Journal of Thrombosis and Thrombolysis 25:1, 61-66
CrossRef129
Albert L. Waldo. (2008) Anticoagulation: Stroke Prevention in Patients with Atrial Fibrillation. Medical Clinics of North America 92:1, 143-159
CrossRef130
Parminder S Chaggar, Kevin S Channer. (2008) Current Issues in Thromboprophylaxis in the Elderly. Drugs & Aging 25:12, 1049-1060
CrossRef131
Benzy J. Padanilam, Eric N. Prystowsky. (2008) Atrial Fibrillation: Goals of Therapy and Management Strategies to Achieve the Goals. Medical Clinics of North America 92:1, 217-235
CrossRef132
Alan S Go, Daniel E Singer. (2008) Stroke prevention in atrial fibrillation: another step sideways. The Lancet 371:9609, 278-280
CrossRef133
Andrzej Wilkołaski, Elżbieta Mazur-Stążka. (2008) Atrial fibrillation (AF) among patients of the Department of Cardiology in Lublin. Annales UMCS, Medicina 63:2, 8-13
CrossRef134
Mark J. Rieder. (2007) Pharmacogenetics of warfarin treatment for potential clinical application. Current Cardiovascular Risk Reports 1:5, 420-426
CrossRef135
S. Al-Mubarak, N. Al-Ali, M. Abou Rass, A. Al-Sohail, A. Robert, K. Al-Zoman, A. Al-Suwyed, S. Ciancio. (2007) Evaluation of dental extractions, suturing and INR on postoperative bleeding of patients maintained on oral anticoagulant therapy. BDJ 203:7, E15-E15
CrossRef136
E. K. ROMBOUTS, F. R. ROSENDAAL, F. J. M. VAN DER MEER. (2007) Daily vitamin K supplementation improves anticoagulant stability. Journal of Thrombosis and Haemostasis 5:10, 2043-2048
CrossRef137
H.C. Koennecke. (2007) Antikoagulation zur Schlaganfallprävention. Der Nervenarzt 78:10, 1124-1129
CrossRef138
Robert R. Quinn, David M.J. Naimark, Matthew J. Oliver, Ahmed M. Bayoumi. (2007) Should Hemodialysis Patients With Atrial Fibrillation Undergo Systemic Anticoagulation? A Cost-Utility Analysis. American Journal of Kidney Diseases 50:3, 421-432
CrossRef139
J. Paul Leigh, Richard H. White. (2007) An economic model of adverse events and costs for oral anticoagulants used for atrial fibrillation. Current Medical Research and Opinion 23:9, 2071-2081
CrossRef140
P. Kirchhof, G. Breithardt. (2007) Therapie von Vorhofflimmern. Der Internist 48:8, 819-831
CrossRef141
Gabriel J. Escobar, Petra Liljestrand, Esther S. Hudes, Donna M. Ferriero, Yvonne W. Wu, Rita J. Jeremy, Thomas B. Newman. (2007) Five-Year Neurodevelopmental Outcome of Neonatal Dehydration. The Journal of Pediatrics 151:2, 127-133.e1
CrossRef142
Jonathan Mant, FD Richard Hobbs, Kate Fletcher, Andrea Roalfe, David Fitzmaurice, Gregory YH Lip, Ellen Murray. (2007) Warfarin versus aspirin for stroke prevention in an elderly community population with atrial fibrillation (the Birmingham Atrial Fibrillation Treatment of the Aged Study, BAFTA): a randomised controlled trial. The Lancet 370:9586, 493-503
CrossRef143
Margaret C. Fang, Alan S. Go, Yuchiao Chang, Elaine M. Hylek, Lori E. Henault, Nancy G. Jensvold, Daniel E. Singer. (2007) Death and Disability from Warfarin-Associated Intracranial and Extracranial Hemorrhages. The American Journal of Medicine 120:8, 700-705
CrossRef144
Maria I Aguilar, Robert Hart, Lesly A Pearce, Maria I Aguilar. 2007. Oral anticoagulants versus antiplatelet therapy for preventing stroke in patients with non-valvular atrial fibrillation and no history of stroke or transient ischemic attacks. .
CrossRef145
Margaret C. Fang, Jane Chen, Michael W. Rich. (2007) Atrial Fibrillation in the Elderly. The American Journal of Medicine 120:6, 481-487
CrossRef146
Jerry H. Gurwitz, Terry S. Field, Martha J. Radford, Leslie R. Harrold, Richard Becker, George Reed, Kristin DeBellis, Jason Moldoff, Nancy Verzier. (2007) The Safety of Warfarin Therapy in the Nursing Home Setting. The American Journal of Medicine 120:6, 539-544
CrossRef147
D. J. MEIER, S. SEVA, W. P. FAY. (2007) A comparison of anticoagulation results of patients managed with narrow vs. standard international normalized ratio target ranges. Journal of Thrombosis and Haemostasis 5:6, 1332-1333
CrossRef148
G.Y.H. Lip, G. Agnelli, A.A. Thach, E. Knight, D. Rost, M.J.D. Tangelder. (2007) Oral anticoagulation in atrial fibrillation: A pan-European patient survey. European Journal of Internal Medicine 18:3, 202-208
CrossRef149
Erik J. Altman, Hannah I. Lipman. (2007) Atrial Fibrillation Ablation Procedures in the Geriatric Population. The American Journal of Geriatric Cardiology 16:5, 315-318
CrossRef150
Natan M Bornstein, Eitan Auriel. (2007) Antithrombotic treatment and stroke severity in patients with atrial fibrillation. Nature Clinical Practice Neurology 3:5, 252-253
CrossRef151
John R. Doty, Donald B. Doty, Kent W. Jones, Jean H. Flores, Marlene Mensah, Bruce B. Reid, Stephen E. Clayson, Greg Snow, Emily Righter, Roger C. Millar. (2007) Comparison of standard Maze III and radiofrequency Maze operations for treatment of atrial fibrillation. The Journal of Thoracic and Cardiovascular Surgery 133:4, 1037-1044
CrossRef152
Elaine M Hylek. (2007) Does preadmission anticoagulation therapy reduce stroke severity in patients with atrial fibrillation?. Nature Clinical Practice Cardiovascular Medicine 4:4, 186-187
CrossRef153
M. Marietta, P. Pedrazzi, M. Girardis, G. Torelli. (2007) Intracerebral haemorrhage: an often neglected medical emergency. Internal and Emergency Medicine 2:1, 38-45
CrossRef154
Lars Frost, Ljubica Vukelic Andersen, Peter Vestergaard, Steen Husted, Leif Spange Mortensen. (2007) Trend in Mortality after Stroke with Atrial Fibrillation. The American Journal of Medicine 120:1, 47-53
CrossRef155
2007. A. , 3-25.
CrossRef156
Caroline Schmidt-Lucke, W. Dieter Paar, Christoph Stellbrink, Uwe Nixdorff, Thomas Hofmann, Jürgen Meurer, Rolf Grewe, Werner Günther Daniel, Peter Hanrath, Andreas Mügge, Helmut U. Klein, Jan André Schmidt-Lucke. (2007) Quality of anticoagulation with unfractionated heparin plus phenprocoumon for the prevention of thromboembolic complications in cardioversion for non-valvular atrial fibrillation. Sub-analysis from the Anticoagulation in Cardioversion using Enoxaparin (ACE) trial. Thrombosis Research 119:1, 27-34
CrossRef157
Cheng-Hung Lee, Chun-Chi Chen, Ming-Shyan Chern. (2007) Thrombolytic Therapy for Acute Left Atrial Thrombus Formation in One Patient With Heart Failure and Atrial Fibrillation. Circulation Journal 71:4, 604-607
CrossRef158
Daniela Poli, Emilia Antonucci, Rossella Marcucci, Cinzia Fatini, Brunetto Alterini, Lucia Mannini, Michela Falciani, Rosanna Abbate, Gian Franco Gensini, Domenico Prisco. (2007) Risk of bleeding in very old atrial fibrillation patients on warfarin: Relationship with ageing and CHADS2 score. Thrombosis Research 121:3, 347-352
CrossRef159
Maria I. Aguilar, Robert G. Hart, Carlos S. Kase, William D. Freeman, Barbara J. Hoeben, Rosa C. García, Jack E. Ansell, Stephan A. Mayer, Bo Norrving, Jonathan Rosand, Thorsten Steiner, Eelco F.M. Wijdicks, Takenori Yamaguchi, Masahiro Yasaka. (2007) Treatment of Warfarin-Associated Intracerebral Hemorrhage: Literature Review and Expert Opinion. Mayo Clinic Proceedings 82:1, 82-92
CrossRef160
M. I. Aguilar, R. G. Hart, C. S. Kase, W. D. Freeman, B. J. Hoeben, R. C. Garcia, J. E. Ansell, S. A. Mayer, B. Norrving, J. Rosand, T. Steiner, E. F. M. Wijdicks, T. Yamaguchi, M. Yasaka. (2007) Treatment of Warfarin-Associated Intracerebral Hemorrhage: Literature Review and Expert Opinion. Mayo Clinic Proceedings 82:1, 82-92
CrossRef161
Thomas G. DeLoughery. 2007. Anticoagulation for Atrial Fibrillation and Prosthetic Cardiac Valves. , 737-746.
CrossRef162
(2006) ACC/AHA/ESC: Guías de Práctica Clínica 2006 para el manejo de pacientes con fibrilación auricular. Versión resumida. Revista Española de Cardiología 59:12, 1329.e1-1329.e64
CrossRef163
Joel Dunning, Tom Treasure, Michael Versteegh, Samer A.M. Nashef. (2006) Guidelines on the prevention and management of de novo atrial fibrillation after cardiac and thoracic surgery. European Journal of Cardio-Thoracic Surgery 30:6, 852-872
CrossRef164
MI Aguilar, R Hart, LA Pearce, Maria Aguilar. 2006. Oral anticoagulants versus antiplatelet therapy for preventing stroke in patients with non-valvular atrial fibrillation and no history of stroke or transient ischemic attacks. .
CrossRef165
Stéphane Ederhy, Ariel Cohen. (2006) Optimising stroke prevention in non-valvular atrial fibrillation. Expert Opinion on Pharmacotherapy 7:15, 2079-2094
CrossRef166
M. PACIARONI, G. AGNELLI, V. CASO, M. VENTI, A. ALBERTI, P. MILIA, G. SILVESTRELLI, S. BIAGINI. (2006) Prior use of antithrombotic agents and neurological functional outcome at discharge in patients with ischemic stroke. Journal of Thrombosis and Haemostasis 4:9, 1957-1961
CrossRef167
Martin O'Donnell, Wes Oczkowski, Jiming Fang, Clive Kearon, Jaime Silva, Christine Bradley, Gordon Guyatt, Linda Gould, Cami D'Uva, Moira Kapral, Frank Silver. (2006) Preadmission antithrombotic treatment and stroke severity in patients with atrial fibrillation and acute ischaemic stroke: an observational study. The Lancet Neurology 5:9, 749-754
CrossRef168
Radoslaw Kazmierski. (2006) Predictors of early mortality in patients with ischemic stroke. Expert Review of Neurotherapeutics 6:9, 1349-1362
CrossRef169
P. Halbfaß, A. Plewan, K. Dennig, C. Kolb, C. Schmitt. (2006) TEE-geführte Kardioversion bei Patienten mit Vorhofflimmern ohne vorherige Antikoagulation. Herzschrittmachertherapie & Elektrophysiologie 17:3, 127-132
CrossRef170
Margaret C. Fang, Alan S. Go, Elaine M. Hylek, Yuchiao Chang, Lori E. Henault, Nancy G. Jensvold, Daniel E. Singer. (2006) Age and the Risk of Warfarin-Associated Hemorrhage: The Anticoagulation and Risk Factors In Atrial Fibrillation Study. Journal of the American Geriatrics Society 54:8, 1231-1236
CrossRef171
Katrin Groebke Zbinden, David W. Banner, Kurt Hilpert, Jacques Himber, Thierry Lavé, Markus A. Riederer, Martin Stahl, Thomas B. Tschopp, Ulrike Obst-Sander. (2006) Dose-dependent antithrombotic activity of an orally active tissue factor/factor VIIa inhibitor without concomitant enhancement of bleeding propensity. Bioorganic & Medicinal Chemistry 14:15, 5357-5369
CrossRef172
Valentin Fuster, Lars E. Rydén, David S. Cannom, Harry J. Crijns, Anne B. Curtis, Kenneth A. Ellenbogen, Jonathan L. Halperin, Jean-Yves Le Heuzey, G. Neal Kay, James E. Lowe, S. Bertil Olsson, Eric N. Prystowsky, Juan Luis Tamargo, Samuel Wann. (2006) ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation. Journal of the American College of Cardiology 48:4, e149-e246
CrossRef173
Valentin Fuster, Lars E. Rydén, David S. Cannom, Harry J. Crijns, Anne B. Curtis, Kenneth A. Ellenbogen, Jonathan L. Halperin, Jean-Yves Le Heuzey, G. Neal Kay, James E. Lowe, S. Bertil Olsson, Eric N. Prystowsky, Juan Luis Tamargo, Samuel Wann. (2006) ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation—Executive Summary. Journal of the American College of Cardiology 48:4, 854-906
CrossRef174
Dean Schillinger, Frances Wang, Maytrella Rodriguez, Andrew Bindman, Edward L. Machtinger. (2006) The Importance of Establishing Regimen Concordance in Preventing Medication Errors in Anticoagulant Care. Journal of Health Communication 11:6, 555-567
CrossRef175
N. J. G. M. VEEGER, M. PIERSMA-WICHERS, H. L. HILLEGE, H. J. G. M. CRIJNS, J. VAN DER MEER. (2006) Early detection of patients with a poor response to vitamin K antagonists: the clinical impact of individual time within target range in patients with heart disease. Journal of Thrombosis and Haemostasis 4:7, 1625-1627
CrossRef176
William B. Kannel, Philip A. Wolf. (2006) Peripheral and cerebral atherothrombosis and cardiovascular events in different vascular territories: Insights from the framingham study. Current Atherosclerosis Reports 8:4, 317-323
CrossRef177
S. Zellerhoff, A. Goette, P. Kirchhof. (2006) Antikoagulation bei Vorhofflimmern. Herzschrittmachertherapie & Elektrophysiologie 17:2, 89-94
CrossRef178
T. D. SZUCS, M. BRAMKAMP. (2006) Pharmacoeconomics of anticoagulation therapy for stroke prevention in atrial fibrillation: a review. Journal of Thrombosis and Haemostasis 4:6, 1180-1185
CrossRef179
H. B. Huttner, E. Jüttler, A. Hug, M. Köhrmann, P. D. Schellinger, T. Steiner. (2006) Antikoagulanzienassoziierte Hirnblutungen. Der Nervenarzt 77:6, 671-681
CrossRef180
Luke R Bereznicki, Gregory M Peterson, Shane L Jackson, Ella C Jeffrey. (2006) The risks of warfarin use in the elderly. Expert Opinion on Drug Safety 5:3, 417-431
CrossRef181
Vincent E. Hagens, Dirk J. Van Veldhuisen, Harry J. G. M. Crijns, Isabelle C. Van Gelder. (2006) Implication from Randomized Trials of Rate and Rhythm Controls on Management of Patients with Persistent Atrial Fibrillation. Annals of Noninvasive Electrocardiology 11:2, 170-186
CrossRef182
Chaitanya Sarawate, Mirko V. Sikirica, Vincent J. Willey, Michael F. Bullano, Ole Hauch. (2006) Monitoring anticoagulation in atrial fibrillation. Journal of Thrombosis and Thrombolysis 21:2, 191-198
CrossRef183
Martha C. Tissot Van Patot, Ashley E. Hill, Colleen Dingmann, Lawrence Gaul, Kelly Fralick, Uwe Christians, Benjamin Honigman, M.D. Salman. (2006) Risk of Impaired Coagulation in Warfarin Patients Ascending to Altitude (>2400 m). High Altitude Medicine & Biology 7:1, 39-46
CrossRef184
L. Boulanger, J. Kim, M. Friedman, O. Hauch, T. Foster, J. Menzin. (2006) Patterns of use of antithrombotic therapy and quality of anticoagulation among patients with non-valvular atrial fibrillation in clinical practice. International Journal of Clinical Practice 60:3, 258-264
CrossRef185
David A. Garcia, Susan Regan, Mark Crowther, Elaine M. Hylek. (2006) The Risk of Hemorrhage Among Patients With Warfarin-Associated Coagulopathy. Journal of the American College of Cardiology 47:4, 804-808
CrossRef186
Dorothy S. Lo, Christian G. Rabbat, Catherine M. Clase. (2006) Thromboembolism and anticoagulant management in hemodialysis patients: A practical guide to clinical management. Thrombosis Research 118:3, 385-395
CrossRef187
Anders Odén, Martin Fahlén, Robert G. Hart. (2006) Optimal INR for prevention of stroke and death in atrial fibrillation: a critical appraisal. Thrombosis Research 117:5, 493-499
CrossRef188
Eduard Shantsila, Timothy Watson, Gregory Y H Lip. (2006) Anticoagulation for Stroke Prevention. PharmacoEconomics 24:10, 1035-1038
CrossRef189
Masahiro Yasaka, Hiroaki Naritomi, Kazuo Minematsu. (2006) Ischemic stroke associated with brief cessation of warfarin. Thrombosis Research 118:2, 290-293
CrossRef190
Gregory Y.H. Lip, Steven J. Edwards. (2006) Stroke prevention with aspirin, warfarin and ximelagatran in patients with non-valvular atrial fibrillation: A systematic review and meta-analysis. Thrombosis Research 118:3, 321-333
CrossRef191
Katrin Groebke Zbinden, Ulrike Obst-Sander, Kurt Hilpert, Holger Kühne, David W. Banner, Hans-Joachim Böhm, Martin Stahl, Jean Ackermann, Leo Alig, Lutz Weber, Hans Peter Wessel, Markus A. Riederer, Thomas B. Tschopp, Thierry Lavé. (2005) Selective and orally bioavailable phenylglycine tissue factor/factor VIIa inhibitors. Bioorganic & Medicinal Chemistry Letters 15:23, 5344-5352
CrossRef192
Robert G. Hart. (2005) Atrial fibrillation and stroke: Four treatment controversies. Current Treatment Options in Neurology 7:6, 491-498
CrossRef193
Albert L. Waldo, Richard C. Becker, Victor F. Tapson, Kevin J. Colgan. (2005) Hospitalized Patients With Atrial Fibrillation and a High Risk of Stroke Are Not Being Provided With Adequate Anticoagulation. Journal of the American College of Cardiology 46:9, 1729-1736
CrossRef194
Maria I Aguilar, Robert Hart, Robert Hart. 2005. Antiplatelet therapy for preventing stroke in patients with non-valvular atrial fibrillation and no previous history of stroke or transient ischemic attacks. .
CrossRef195
Theodore Darkow, Ann M. Vanderplas, Kim H. Lew, Jennifer Kim, Ole Hauch. (2005) Treatment patterns and real-world effectiveness of warfarin in nonvalvular atrial fibrillation within a managed care system*. Current Medical Research and Opinion 21:10, 1583-1594
CrossRef196
Joan Parker Frizzell. (2005) Acute Stroke. AACN Clinical Issues: Advanced Practice in Acute and Critical Care 16:4, 421-440
CrossRef197
Robert W. Rho, Richard L. Page. (2005) Asymptomatic Atrial Fibrillation. Progress in Cardiovascular Diseases 48:2, 79-87
CrossRef198
Pedro Laguna, Alfonso Martín, Carmen del Arco, Isabel Millán, Pedro Gargantilla, . (2005) Differences among Clinical Classification Schemes for Predicting Stroke in Atrial Fibrillation: Implications for Therapy in Daily Practice. Academic Emergency Medicine 12:9, 828-834
CrossRef199
Alan S. Go, Margaret C. Fang, Daniel E. Singer. (2005) Antithrombotic Therapy for Stroke Prevention in Atrial Fibrillation. Progress in Cardiovascular Diseases 48:2, 108-124
CrossRef200
B. INDREDAVIK, G. ROHWEDER, S. LYDERSEN. (2005) Frequency and effect of optimal anticoagulation before onset of ischaemic stroke in patients with known atrial fibrillation. Journal of Internal Medicine 258:2, 133-144
CrossRef201
Brian Olshansky, Hongsheng Guo. (2005) Acute anticoagulation adjustment in patients with atrial fibrillation at risk for stroke: approaches, strategies, risks and benefits. Expert Review of Cardiovascular Therapy 3:4, 571-590
CrossRef202
Deepak Voora, Howard L McLeod, Charles Eby, Brian F Gage. (2005) The pharmacogenetics of coumarin therapy. Pharmacogenomics 6:5, 503-513
CrossRef203
Peter Bernhardt, Harald Schmidt, Christoph Hammerstingl, Berndt Lüderitz, Heyder Omran. (2005) Incidence of Cerebral Embolism after Cardioversion of Atrial Fibrillation: A Prospective Study with Transesophageal Echocardiography and Cerebral Magnetic Resonance Imaging. Journal of the American Society of Echocardiography 18:6, 649-653
CrossRef204
Edith A. Nutescu, Cathy M. Helgason. (2005) Concomitant drug, dietary, and lifestyle issues in patients with atrial fibrillation receiving anticoagulation therapy for stroke prophylaxis. Current Treatment Options in Cardiovascular Medicine 7:3, 241-250
CrossRef205
Meghan E. Kenner, Roger E. Kelley. (2005) Update on stroke prevention. Comprehensive Therapy 31:2, 113-118
CrossRef206
Bipinpreet S Nagra, Bharat K Kantharia. (2005) Anticoagulation in nonvalvular atrial fibrillation. Future Cardiology 1:3, 373-380
CrossRef207
Robert J. Anderson, Christine Divers, Irene von Hennigs. (2005) Drug Interaction Exposure in Chronic Atrial Fibrillation Patients Maintained on Warfarin. Journal of Thrombosis and Thrombolysis 19:2, 123-124
CrossRef208
Jonathan L. Halperin. (2005) Anticoagulation for Atrial Fibrillation in the Elderly. The American Journal of Geriatric Cardiology 14:2, 81-86
CrossRef209
H. V
ller, J. Glatz, U. Taborski, A. Bernardo, C. Dovifat, K. Heidinger. (2005) Self-Management of oral Anticoagulation in nonvalvular Atrial Fibrillation (SMAAF study). Zeitschrift f
CrossRef210
A. Pape, J. Tebbenjohanns. (2005) Antikoagulation bei Vorhofflimmern. Intensivmedizin + Notfallmedizin 42:1, 74-78
CrossRef211
C. R. Harley, A. A. Riedel, O. Hauch, M. Nelson, G. Wygant, M. Reynolds. (2005) Anticoagulation therapy in patients with chronic atrial fibrillation: a retrospective claims data analysis*. Current Medical Research and Opinion 21:2, 215-222
CrossRef212
Bob A J van Deelen, Patricia M L A van den Bemt, Toine C G Egberts, Annelies van ??t Hoff, Huub A A M Maas. (2005) Cognitive Impairment as Determinant for Sub-Optimal Control of Oral Anticoagulation Treatment in Elderly Patients with Atrial Fibrillation. Drugs & Aging 22:4, 353-360
CrossRef213
Chun-ming Cheung, Tak-hong Tsoi, Chen-ya Huang. (2005) The Lowest Effective Intensity of Prophylactic Anticoagulation for Patients with Atrial Fibrillation. Cerebrovascular Diseases 20:2, 114-119
CrossRef214
Sebastian Harder, Philipp Fischer, Markus Krause-Sch
CrossRef215
Page, Richard L., . (2004) Newly Diagnosed Atrial Fibrillation. New England Journal of Medicine 351:23, 2408-2416
Full Text216
Christopher J Boos, Gregory YH Lip. (2004) Novel therapies for the prevention of stroke. Expert Opinion on Investigational Drugs 13:12, 1615-1630
CrossRef217
Ritu Saxena, Peter J Koudstaal, Ritu Saxena. 2004. Anticoagulants versus antiplatelet therapy for preventing stroke in patients with nonrheumatic atrial fibrillation and a history of stroke or transient ischemic attack. .
CrossRef218
A. Hug, A. Aschoff, S. Schwab. (2004) Spontane intrazerebrale Blutungen. Der Nervenarzt 75:10, 953-961
CrossRef219
Ann K. Wittkowsky, Kenneth W. Kenyon. (2004) The Role of Oral Direct Thrombin Inhibitors in Atrial Fibrillation. Pharmacotherapy 24:10 Part 2, 190S-198S
CrossRef220
Edith A. Nutescu, Alex C. Spyropoulos, Kerry W. Cranmer. (2004) Oral Anticoagulation: Preparing for Change. Journal of the American Medical Directors Association 5:5, 2-10
CrossRef221
Palle Petersen. (2004) New approaches to anticoagulation in atrial fibrillation. Current Cardiology Reports 6:5, 354-364
CrossRef222
Geno Merli, Howard H. Weitz. (2004) The decision to anticoagulate: Assessing whether benefits outweigh the risks for patients with atrial fibrillation. Clinical Cardiology 27:6, 313-320
CrossRef223
Christopher Bibbo. (2004) The Assessment and Perioperative Management of Patients With Rheumatoid Arthritis. Techniques in Foot & Ankle Surgery 3:2, 126-135
CrossRef224
H. R. Vries. (2004) Niet-valvulair boezemfibrilleren: mate van antistolling en invloed op het herseninfarct. Medisch-Farmaceutische Mededelingen 42:5, 129-129
CrossRef225
Ritu Saxena, Peter J Koudstaal, Ritu Saxena. 2004. Anticoagulants for preventing stroke in patients with nonrheumatic atrial fibrillation and a history of stroke or transient ischaemic attack. .
CrossRef226
Mark A Crowther, Jeffrey I Weitz. (2004) Ximelagatran: the first oral direct thrombin inhibitor. Expert Opinion on Investigational Drugs 13:4, 403-413
CrossRef227
Richard L Mueller. (2004) First-generation agents: aspirin, heparin and coumarins. Best Practice & Research Clinical Haematology 17:1, 23-53
CrossRef228
Jonathan L Halperin. (2004) Antithrombotic therapy in atrial fibrillation: ximelagatran, an oral direct thrombin inhibitor. Expert Review of Cardiovascular Therapy 2:2, 163-174
CrossRef229
EF Epstein. (2004) Ximelagatran or warfarin in atrial fibrillation?. The Lancet 363:9410, 736
CrossRef230
Edith A. Nutescu, Alex C. Spyropoulos, Kerry W. Cranmer. (2004) Oral Anticoagulation: Preparing for Change. Journal of the American Medical Directors Association 5:suppl, 2
CrossRef231
Kazuo MINEMATSU. (2004) Japanese Journal of Thrombosis and Hemostasis 15:2, 119-121
CrossRef232
Geoffrey A Donnan. (2004) Stroke: prediction, prevention, and outcome. The Lancet Neurology 3:1, 9
CrossRef233
(2003) Oral Anticoagulation and Stroke in Atrial Fibrillation. New England Journal of Medicine 349:24, 2360-2361
Full Text234
Hart, Robert G., . (2003) Atrial Fibrillation and Stroke Prevention. New England Journal of Medicine 349:11, 1015-1016
Full Text
- Letters
