Atrial Fibrillation, Stroke, and Anticoagulation in Medicare Beneficiaries: Trends by Age, Sex, and Race, 1992–2010
Atrial Fibrillation Saturday, July 5th, 2014J Am Heart Assoc.: 6/3/14
Background We evaluated temporal trends in ischemic stroke and warfarin use among demographic subsets of the US Medicare population that are not well represented in randomized trials of warfarin for stroke prevention in nonvalvular atrial fibrillation (AF).
Methods and Results One‐year cohorts of Medicare–primary payer patients (1992–2010) were created using the Medicare 5% sample. International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to identify AF and ischemic and hemorrhagic stroke; ≥3 consecutive prothrombin time claims were used to identify warfarin use. Ischemic stroke rates (per 1000 patient‐years) decreased markedly from 1992 to 2010. Among women, rates decreased from 37.1 to 13.6 for ages 65 to 74 years, from 55.2 to 16.5 for ages 74 to 84, and from 66.9 to 22.9 for age ≥85; warfarin use increased 31% to 59%, 27% to 63%, and 15% to 49%, respectively. Among men, rates decreased from 33.8 to 11.7 for ages 65 to 74 years, from 49.2 to 13.8 for ages 75 to 84, and from 51.5 to 18.0 for age ≥ 85; warfarin use increased 34% to 63%, 28% to 66%, and 15% to 55%, respectively. Read More
