Evidence map›Paper›PMID 27428322›Full record

Observational studyInternational journal of cardiology2016

Warfarin treatment and risk of myocardial infarction - A cohort study of patients with atrial fibrillation treated in primary health care.

Per Wändell, Axel C Carlsson, Martin J Holzmann, Johan Ärnlöv, Sven-Erik Johansson, Jan Sundquist, Kristina Sundquist

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in International journal of cardiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.7field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 1 country.

Per WändellDivision of Family Medicine, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Huddinge, Sweden; Academic Primary Healthcare Centre, Stockholm County Council, Huddinge, Sweden. Electronic address: per.wandell@ki.se.
Axel C CarlssonDivision of Family Medicine, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Huddinge, Sweden; Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden.
Martin J HolzmannDepartment of Emergency Medicine, Karolinska University Hospital, Stockholm, Sweden; Department of Internal Medicine, Karolinska Institutet, Stockholm, Sweden.
Johan ÄrnlövDepartment of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden; School of Health and Social Studies, Dalarna University, Falun, Sweden.
Sven-Erik JohanssonCentre for Primary Health Care Research, Lund University, Malmö, Sweden.
Jan SundquistCentre for Primary Health Care Research, Lund University, Malmö, Sweden.
Kristina SundquistCentre for Primary Health Care Research, Lund University, Malmö, Sweden.
Lund University · SEDalarna University · SEKarolinska University Hospital · SEStockholm County Council · SEUppsala University · SE

Funding

Neighborhoods and Coronary Disease: Exploring Mechanisms and Improving MethodsR01HL116381 · NHLBI · LUNDS UNIVERSITET · PI SUNDQUIST, KRISTINA · 2014 to 2017
$1.9M
NHLBI NIH HHS R01 HL116381
6 · The paper itself

Abstract

objectiveTo study the risk of myocardial infarction (MI) in patients with atrial fibrillation (AF) treated in primary health care with warfarin or acetylsalicylic acid (ASA, aspirin).

methodsThe study population included subjects (n=12,283) 45years or older diagnosed with AF who were treated in 75 primary care centres in Sweden between 2001 and 2007. MI was defined as a hospital stay for MI during 2001 through 2010 registered in the Swedish Patient Register. Associations between warfarin or ASA treatment and incident MI were explored using Cox regression analysis, by estimating hazard ratios (HRs) and 95% confidence intervals (95% CIs). Adjustment was made for age, socio-economic factors and cardio-vascular co-morbidity.

resultsPersistent treatment ("per protocol" treatment) with warfarin alone was present among 32.4% of women and 37.4% of men, and with ASA alone among 30.0% of women and 28.1% of men. The fully adjusted HRs for MI, compared to those with no antithrombotic treatment, with warfarin treatment for women were 0.26 (95% CI 0.16-0.41) and for men 0.28 (95% CI 0.20-0.39); and the corresponding HRs for those treated with ASA were for women 0.57 (95% CI 0.37-0.87), and for men 0.44 95% CI (0.31-0.63). The fully adjusted HR for MI when comparing patients with warfarin treatment to those with ASA treatment was for women 0.46 (95% CI 0.27-0.80), and for men 0.58 (95% CI 0.38-0.89).

conclusionsWarfarin seems to prevent MI among AF patients in a primary healthcare setting, which emphasizes the importance of persistent anticoagulant treatment in those patients.

Indexed as

AgedAged, 80 and overAnticoagulantsAtrial FibrillationCohort StudiesFemaleFollow-Up StudiesHumansMaleMiddle AgedMyocardial InfarctionPrimary Health CareRisk FactorsSwedenTreatment OutcomeWarfarinAnticoagulantsWarfarinAnticoagulantsAntiplateletsAtrial fibrillationCo-morbidityFollow-upGenderMyocardial infarction

Identifiers

PMID27428322
PMCPMC5417351
OpenAlexW2466241837

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.