Skip to main content
Journal cover image

Warfarin use and outcomes in patients with atrial fibrillation complicating acute coronary syndromes.

Publication ,  Journal Article
Lopes, RD; Starr, A; Pieper, CF; Al-Khatib, SM; Newby, LK; Mehta, RH; Van de Werf, F; Mahaffey, KW; Armstrong, PW; Harrington, RA; White, HD ...
Published in: Am J Med
February 2010

BACKGROUND: We examined warfarin use at discharge (according to Congestive heart failure, Hypertension, Age>75 years, Diabetes, Prior Stroke/transient ischemic attack score and bleeding risk) and its association with 6-month death or myocardial infarction in patients with post-acute coronary syndrome atrial fibrillation. METHODS: Of the 23,208 patients enrolled in the Platelet IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy, Platelet IIb/IIIa Antagonist for the Reduction of Acute Coronary Syndrome Events in a Global Organization Network A, and Superior Yield of the New Strategy of Enoxaparin, Revascularization and Glycoprotein IIb/IIIa Inhibitors trials, 4.0% (917 patients) had atrial fibrillation as an in-hospital complication and were discharged alive. Cox proportional hazards models were performed to assess 6-month outcomes after discharge. RESULTS: Overall, 13.5% of patients with an acute coronary syndrome complicated by atrial fibrillation received warfarin at discharge. Warfarin use among patients with atrial fibrillation had no relation with estimated stroke risk; similar rates were observed across Congestive heart failure, Hypertension, Age>75 years, Diabetes, Prior Stroke/transient ischemic attack (CHADS(2)) scores (0, 13%; 1, 14%; > or = 2, 13%) and across different bleeding risk categories (low risk, 11.9%; intermediate risk, 13.3%; high risk, 11.1%). Among patients with in-hospital atrial fibrillation, warfarin use at discharge was independently associated with a lower risk of death or myocardial infarction within 6 months of discharge (hazard ratio 0.39; 95% confidence interval, 0.15-0.98). CONCLUSION: Warfarin is associated with better 6-month outcomes among patients with atrial fibrillation complicating an acute coronary syndrome, but its use is not related to CHADS(2) score or bleeding risk.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Am J Med

DOI

EISSN

1555-7162

Publication Date

February 2010

Volume

123

Issue

2

Start / End Page

134 / 140

Location

United States

Related Subject Headings

  • Warfarin
  • Treatment Outcome
  • Retrospective Studies
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Hospitalization
  • General & Internal Medicine
  • Fibrinolytic Agents
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Lopes, R. D., Starr, A., Pieper, C. F., Al-Khatib, S. M., Newby, L. K., Mehta, R. H., … Granger, C. B. (2010). Warfarin use and outcomes in patients with atrial fibrillation complicating acute coronary syndromes. Am J Med, 123(2), 134–140. https://doi.org/10.1016/j.amjmed.2009.09.015
Lopes, Renato D., Aijing Starr, Carl F. Pieper, Sana M. Al-Khatib, L Kristin Newby, Rajendra H. Mehta, Frans Van de Werf, et al. “Warfarin use and outcomes in patients with atrial fibrillation complicating acute coronary syndromes.Am J Med 123, no. 2 (February 2010): 134–40. https://doi.org/10.1016/j.amjmed.2009.09.015.
Lopes RD, Starr A, Pieper CF, Al-Khatib SM, Newby LK, Mehta RH, et al. Warfarin use and outcomes in patients with atrial fibrillation complicating acute coronary syndromes. Am J Med. 2010 Feb;123(2):134–40.
Lopes, Renato D., et al. “Warfarin use and outcomes in patients with atrial fibrillation complicating acute coronary syndromes.Am J Med, vol. 123, no. 2, Feb. 2010, pp. 134–40. Pubmed, doi:10.1016/j.amjmed.2009.09.015.
Lopes RD, Starr A, Pieper CF, Al-Khatib SM, Newby LK, Mehta RH, Van de Werf F, Mahaffey KW, Armstrong PW, Harrington RA, White HD, Wallentin L, Granger CB. Warfarin use and outcomes in patients with atrial fibrillation complicating acute coronary syndromes. Am J Med. 2010 Feb;123(2):134–140.
Journal cover image

Published In

Am J Med

DOI

EISSN

1555-7162

Publication Date

February 2010

Volume

123

Issue

2

Start / End Page

134 / 140

Location

United States

Related Subject Headings

  • Warfarin
  • Treatment Outcome
  • Retrospective Studies
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Hospitalization
  • General & Internal Medicine
  • Fibrinolytic Agents