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dc.contributor.authorKjerpeseth, Lars Jøran
dc.contributor.authorEllekjær, Hanne
dc.contributor.authorSelmer, Randi
dc.contributor.authorAriansen, Inger Kristine Holtermann
dc.contributor.authorFuru, Kari
dc.contributor.authorSkovlund, Eva
dc.date.accessioned2018-08-31T06:33:18Z
dc.date.available2018-08-31T06:33:18Z
dc.date.created2018-08-30T13:16:22Z
dc.date.issued2018
dc.identifier.issn0031-6970
dc.identifier.urihttp://hdl.handle.net/11250/2560167
dc.description.abstractPurpose To investigate risk factors for stroke in patients initiating oral anticoagulants for atrial fibrillation in Norway and their association with receiving DOACs versus warfarin. Methods From nationwide registries, we identified naïve users initiating treatment with warfarin, dabigatran, rivaroxaban, or apixaban for atrial fibrillation from 2010 to 2015 in Norway. We studied temporal changes in the CHA2DS2-VASc score and its component risk factors. We used multiple logistic regressions to identify CHA2DS2-VASc risk factors associated with receiving DOACs versus warfarin in 2015. Results From 2010 to 2015, the yearly number of new oral anticoagulant users increased from 7588 to 13,344. All new users initiated warfarin in 2010, while 86% initiated a DOAC in 2015. The mean CHA2DS2-VASc score decreased from 3.2 (SD 1.7) to 3.1 (SD 1.6) in the same period. Vascular disease (0.56 [0.49–0.63]), congestive heart failure (OR 0.65 [95% CI 0.58–0.72]), and diabetes (0.83 [0.73–0.95]) decreased the odds of receiving DOACs instead of warfarin, and ischemic stroke/transient ischemic attack/arterial thromboembolism (1.31 [1.12–1.54]), age 65–74 (1.23 [1.06–1.43]), and female sex (1.22 [1.10–1.36]) increased it. Age ≥ 75 (reference age < 65) and hypertension had no impact. Conclusions The uptake of DOACs was rapid and spurred an increase in new users of oral anticoagulants for atrial fibrillation from 2010 to 2015 in Norway. The mean CHA2DS2-VASc score did not change substantially during this period. Vascular disease, heart failure, and diabetes were associated with initiation of warfarin, and previous stroke, age 65–74 and female sex with initiation of DOACs.nb_NO
dc.language.isoengnb_NO
dc.publisherSpringer Verlagnb_NO
dc.titleRisk factors for stroke and choice of oral anticoagulant in atrial fibrillationnb_NO
dc.typeJournal articlenb_NO
dc.typePeer reviewednb_NO
dc.description.versionacceptedVersionnb_NO
dc.source.journalEuropean Journal of Clinical Pharmacologynb_NO
dc.identifier.doi10.1007/s00228-018-2540-3
dc.identifier.cristin1605543
dc.description.localcodeThis is a post-peer-review, pre-copyedit version of an article published in [European Journal of Clinical Pharmacology] Locked until 16.8.2019 due to copyright restrictions. The final authenticated version is available online at: https://doi.org/10.1007/s00228-018-2540-3nb_NO
cristin.unitcode194,65,20,0
cristin.unitcode194,65,30,0
cristin.unitnameInstitutt for samfunnsmedisin og sykepleie
cristin.unitnameInstitutt for nevromedisin og bevegelsesvitenskap
cristin.ispublishedtrue
cristin.fulltextpostprint
cristin.qualitycode2


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