{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T13:18:21Z","timestamp":1769087901605,"version":"3.49.0"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T00:00:00Z","timestamp":1767312000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Limited data exist on characteristics and patterns associated with patients with atrial fibrillation (AF) who encounter first-ever ischemic stroke (IS) while not on oral anticoagulation (OAC) therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From a nationwide registry-linkage database including all patients with AF in Finland from 2007 to 2017, we included those with IS after diagnosis of AF and those without IS. Factors associated with non-OAC use among IS patients were examined using logistic regression, with separate models for independent variables and risk scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 174,094 patients with new-onset AF, 11,680 (6.7%) patients (56.9% female; mean age 79.0\u2009years) experienced IS. A total of 7507 (64.3%) of IS patients were not on OAC at the time of IS (mean age 78.9\u2009years; 57.2% female). The proportion of non-OAC decreased from 77.2% to 45.6% over the study period. In the adjusted logistic regression model, the strongest factor associated with non-OAC was CHA2DS2-VA score of 0 points (OR 4.561; 95% CI, 3.097\u20136.718), followed by a score of 1 point (OR 2.382; 95% CI, 1.971\u20132.879). Other significant independent factors associated with non-OAC use were alcohol abuse (OR 2.282; 95% CI, 1.805\u20132.885), liver dysfunction (OR 2.120; 95% CI, 1.335\u20133.367), renal dysfunction (OR 1.430; 95% CI, 1.200\u20131.703), dementia (OR 1.394; 95% CI, 1.227\u20131.583), prior myocardial infarction (OR 1.346; 95% CI, 1.181\u20131.535), age &amp;lt;65\u2009years (OR 1.274; 95% CI, 1.034\u20131.571), lowest income (OR 1.232; 95% CI, 1.104\u20131.374), female sex (OR 1.177; 95% CI, 1.077\u20131.287), and antiplatelets\/NSAID use (OR 1.133; 95% CI, 1.042\u20131.231).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Less than 2% of AF patients experienced IS during study period and among these around 63% were without appropriate OAC therapy at the time of the IS. However, decreasing trend of non-OAC use was identified throughout the study period.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/esj\/23969873251343857","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T11:01:58Z","timestamp":1768906918000},"source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with oral anticoagulant non-use at first ischemic stroke in atrial fibrillation: A nationwide study"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2296-6621","authenticated-orcid":false,"given":"Marko","family":"Vilpponen","sequence":"first","affiliation":[{"name":"University of Helsinki , Helsinki ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7030-6740","authenticated-orcid":false,"given":"Aapo L","family":"Aro","sequence":"additional","affiliation":[{"name":"Heart and Lung Center , Helsinki University Hospital and University of Helsinki, Helsinki ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9266-8435","authenticated-orcid":false,"given":"Olli","family":"Halminen","sequence":"additional","affiliation":[{"name":"Department of Industrial Engineering and Management , Aalto University, Espoo ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7916-7262","authenticated-orcid":false,"given":"Paula","family":"Tiili","sequence":"additional","affiliation":[{"name":"Primary Health Care Unit , Helsinki University Hospital, Helsinki ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miika","family":"Linna","sequence":"additional","affiliation":[{"name":"Department of Industrial Engineering and Management , Aalto University, Espoo ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7119-2781","authenticated-orcid":false,"given":"Alex","family":"Luojus","sequence":"additional","affiliation":[{"name":"University of Helsinki , Helsinki ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4460-0994","authenticated-orcid":false,"given":"Konsta","family":"Teppo","sequence":"additional","affiliation":[{"name":"Heart Center , Turku University Hospital and University of Turku, Turku ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pirjo","family":"Mustonen","sequence":"additional","affiliation":[{"name":"Heart Center , Turku University Hospital and University of Turku, Turku ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1450-6208","authenticated-orcid":false,"given":"Jari","family":"Haukka","sequence":"additional","affiliation":[{"name":"Department of Public Health , University of Helsinki, Helsinki ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0847-107X","authenticated-orcid":false,"given":"Juha","family":"Hartikainen","sequence":"additional","affiliation":[{"name":"Heart Center , Kuopio University Hospital and University of Eastern Finland, Kuopio ,","place":["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 ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8691-5142","authenticated-orcid":false,"given":"Mika","family":"Lehto","sequence":"additional","affiliation":[{"name":"University of Helsinki , Helsinki ,","place":["Finland"]},{"name":"Department of Internal Medicine , Jorvi Hospital and Helsinki University Hospital, Espoo ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jukka","family":"Putaala","sequence":"additional","affiliation":[{"name":"Department of Neurology , Helsinki University Hospital and University of Helsinki, Helsinki ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,1,1]]},"reference":[{"key":"2026012115125200600_bibr1-23969873251343857","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1001\/jama.2017.1371","article-title":"Association of preceding antithrombotic treatment 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thrombosis, and bleeding: a Danish population-based cohort study","volume":"6","author":"B. 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