{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T13:53:25Z","timestamp":1740146005026,"version":"3.37.3"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,5,10]],"date-time":"2018-05-10T00:00:00Z","timestamp":1525910400000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008723","name":"Suomen L\u00e4\u00e4ketieteen S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008723","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Atrial fibrillation (AF) increases risk of ischemic stroke, and oral anticoagulation (OAC) increases risk of intracerebral hemorrhage (ICH). This study aimed to compare OAC\u2010treated AF patients with an ischemic stroke\/transient ischemic attack (TIA) or spontaneous ICH as their first lifetime cerebrovascular event, especially focusing on patients with therapeutic international normalized ratio (INR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>We assumed that in AF patients suffering ischemic stroke\/TIA or ICH, patient characteristics could be different in patients with therapeutic INR than in patients with warfarin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>FibStroke is a multicenter, retrospective registry collating details of AF patients with ischemic stroke\/TIA or intracranial hemorrhage in 2003\u20132012. This substudy included AF patients on OAC with first lifetime ischemic stroke\/TIA or spontaneous ICH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1457 patients with 1290 ischemic strokes\/TIAs and 167 ICHs were identified. Of these, 553 (42.9%) strokes\/TIAs and 96 (57.5%) ICHs occurred in patients with INR within therapeutic range. During OAC with therapeutic INR, congestive heart failure (odds ratio [OR]: 2.33, 95% confidence interval [CI]: 1.18\u20134.58) and hypercholesterolemia (OR: 2.52, 95% CI: 1.51\u20134.19) were more common in patients with ischemic stroke\/TIA, whereas a history of bleeding (OR: 0.30, 95% CI: 0.11\u20130.82) was less common when compared with patients with ICH. In the whole cohort, renal impairment (OR: 1.86, 95% CI: 1.23\u20132.80) and mechanical valve prosthesis (OR: 4.41, 95% CI: 1.32\u201314.7) were overrepresented in patients with stroke\/TIA, whereas aspirin use (OR: 0.52, 95% CI: 0.30\u20130.91) and high INR (OR: 0.40, 95% CI: 0.33\u20130.48) were overrepresented in patients with ICH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In anticoagulated AF patients with therapeutic INR and first lifetime cerebrovascular event, congestive heart failure and hypercholesterolemia were associated with ischemic stroke\/TIA and history of bleeding with ICH.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22935","type":"journal-article","created":{"date-parts":[[2018,5,10]],"date-time":"2018-05-10T15:17:04Z","timestamp":1525965424000},"page":"608-614","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["How do anticoagulated atrial fibrillation patients who suffer ischemic stroke or spontaneous intracerebral hemorrhage differ?"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6178-8781","authenticated-orcid":false,"given":"Heidi","family":"Lehtola","sequence":"first","affiliation":[{"name":"Department of Medicine Keski\u2010Suomi Central Hospital  Jyvaskyla Finland"},{"name":"Department of Cardiology Oulu University Hospital  Oulu Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juha","family":"Hartikainen","sequence":"additional","affiliation":[{"name":"Heart Center Kuopio University Hospital and University of Eastern Finland  Kuopio Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P\u00e4ivi","family":"Hartikainen","sequence":"additional","affiliation":[{"name":"Neuro Center Kuopio University Hospital  Kuopio Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tuomas","family":"Kiviniemi","sequence":"additional","affiliation":[{"name":"Heart Center Turku University Hospital and University of Turku  Turku Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilpo","family":"Nuotio","sequence":"additional","affiliation":[{"name":"Department of Acute Internal Medicine Turku University Hospital and University of Turku  Turku Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antti","family":"Palom\u00e4ki","sequence":"additional","affiliation":[{"name":"Heart Center Turku University Hospital and University of Turku  Turku Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antti","family":"Ylitalo","sequence":"additional","affiliation":[{"name":"Heart Center Turku University Hospital and University of Turku  Turku Finland"},{"name":"Satakunta Central Hospital  Pori Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0193-568X","authenticated-orcid":false,"given":"K.E. Juhani","family":"Airaksinen","sequence":"additional","affiliation":[{"name":"Heart Center Turku University Hospital and University of Turku  Turku Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pirjo","family":"Mustonen","sequence":"additional","affiliation":[{"name":"Department of Medicine Keski\u2010Suomi Central Hospital  Jyvaskyla Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,5,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-131-7-199910050-00003"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0905561"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009638"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1310907"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1107039"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-0134"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.09.024"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12820"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-1584"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw210"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs109"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.112.650614"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.02.549"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2014.07.015"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.111.967000"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.04.089"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.011353"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198904063201405"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2009.07.048"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa061894"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.112.654145"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13280"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-141-10-200411160-00005"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa022913"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12352"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.08.1623"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000141933.75462.c2"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1105594"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.084996"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.09.051"}],"container-title":["Clinical Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fclc.22935","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.22935","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T16:53:52Z","timestamp":1695488032000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/clc.22935"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5]]},"references-count":30,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2018,5]]}},"alternative-id":["10.1002\/clc.22935"],"URL":"https:\/\/doi.org\/10.1002\/clc.22935","archive":["Portico"],"relation":{},"ISSN":["0160-9289","1932-8737"],"issn-type":[{"type":"print","value":"0160-9289"},{"type":"electronic","value":"1932-8737"}],"subject":[],"published":{"date-parts":[[2018,5]]},"assertion":[{"value":"2017-12-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-02-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-05-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}