{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T22:26:07Z","timestamp":1788128767611,"version":"build-2803163510"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T00:00:00Z","timestamp":1659312000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>We determined the long-term event incidence among elderly patients with nonvalvular atrial fibrillation in terms of history of stroke\/transient ischemic attack (TIA) and oral anticoagulation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Patients aged \u226575 years with documented nonvalvular atrial fibrillation enrolled in the prospective, multicenter, observational All Nippon Atrial Fibrillation in the Elderly Registry between October 2016 and January 2018 were divided into 2 groups according to history of stroke\/TIA. The primary end point was the occurrence of stroke\/systemic embolism within 2 years, and secondary end points were major bleeding and all-cause death within 2 years. Cox models were used to determine whether there was a difference in the hazard of each end point in patients with\/without history of stroke\/TIA, and in ischemic stroke\/TIA survivors taking direct oral anticoagulants versus those taking warfarin.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Of 32\u2009275 evaluable patients (13\u2009793 women [42.7%]; median age, 81.0 years), 7304 (22.6%) had a history of stroke\/TIA. The patients with previous stroke\/TIA were more likely to be male and older and had higher hazard rates of stroke\/systemic embolism (adjusted hazard ratio, 2.25 [95% CI, 1.97\u20132.58]), major bleeding (1.25, 1.05\u20131.49), and all-cause death (1.13, 1.02\u20131.24) than the other groups. Of 6446 patients with prior ischemic stroke\/TIA, 4393 (68.2%) were taking direct oral anticoagulants and 1668 (25.9%) were taking warfarin at enrollment. The risk of stroke\/systemic embolism was comparable between these 2 groups (adjusted hazard ratio, 0.90 [95% CI, 0.71\u20131.14]), while the risk of major bleeding (0.67, 0.48\u20130.94), intracranial hemorrhage (0.57, 0.39\u20130.85), and cardiovascular death (0.71, 0.51\u20130.99) was lower among those taking direct oral anticoagulants.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Patients aged \u226575 years with nonvalvular atrial fibrillation and previous stroke\/TIA more commonly had subsequent ischemic and hemorrhagic events than those without previous stroke\/TIA. Among patients with previous ischemic stroke\/TIA, the risk of hemorrhagic events was lower in patients taking direct oral anticoagulants compared with warfarin.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>REGISTRATION:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique Identifier: UMIN000024006.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.121.038285","type":"journal-article","created":{"date-parts":[[2022,4,20]],"date-time":"2022-04-20T09:00:12Z","timestamp":1650445212000},"page":"2549-2558","source":"Crossref","is-referenced-by-count":10,"title":["Impact of Previous Stroke on Clinical Outcome in Elderly Patients With Nonvalvular Atrial Fibrillation: ANAFIE Registry"],"prefix":"10.1161","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3178-8171","authenticated-orcid":true,"given":"Takeshi","family":"Yoshimoto","sequence":"first","affiliation":[{"name":"Department of Neurology (T. Yoshimoto, M.I.), National Cerebral and Cardiovascular Center, Suita, Japan."},{"name":"Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Japan (T. Yoshimoto)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8346-9845","authenticated-orcid":true,"given":"Kazunori","family":"Toyoda","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Medicine (K.T., T. Yamaguchi), National Cerebral and Cardiovascular Center, Suita, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7102-4048","authenticated-orcid":true,"given":"Masafumi","family":"Ihara","sequence":"additional","affiliation":[{"name":"Department of Neurology (T. Yoshimoto, M.I.), National Cerebral and Cardiovascular Center, Suita, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0775-8936","authenticated-orcid":true,"given":"Hiroshi","family":"Inoue","sequence":"additional","affiliation":[{"name":"Saiseikai Toyama Hospital, Toyama, Japan (H.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2544-8464","authenticated-orcid":true,"given":"Takeshi","family":"Yamashita","sequence":"additional","affiliation":[{"name":"The Cardiovascular Institute, Tokyo, Japan (T. Yamashita, S.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4769-5925","authenticated-orcid":true,"given":"Shinya","family":"Suzuki","sequence":"additional","affiliation":[{"name":"The Cardiovascular Institute, Tokyo, Japan (T. Yamashita, S.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2348-7646","authenticated-orcid":true,"given":"Masaharu","family":"Akao","sequence":"additional","affiliation":[{"name":"Department of Cardiology, NHO Kyoto Medical Center, Kyoto, Japan (M.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8181-9154","authenticated-orcid":true,"given":"Hirotsugu","family":"Atarashi","sequence":"additional","affiliation":[{"name":"AOI Hachioji Hospital, Tokyo, Japan (H.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0096-438X","authenticated-orcid":true,"given":"Takanori","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan (T.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3202-7203","authenticated-orcid":true,"given":"Ken","family":"Okumura","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, Japan (K.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1650-8362","authenticated-orcid":true,"given":"Yukihiro","family":"Koretsune","sequence":"additional","affiliation":[{"name":"NHO Osaka National Hospital, Japan (Y.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9941-8973","authenticated-orcid":true,"given":"Wataru","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Nippon Medical School Department of Medicine, Tokyo, Japan (W.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Tsutsui","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Science, Fukuoka, Japan (H.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Hirayama","sequence":"additional","affiliation":[{"name":"Osaka Police Hospital, Japan (A.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1163-8355","authenticated-orcid":true,"given":"Masahiro","family":"Yasaka","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Medicine and Neurology, Cerebrovascular Center, NHO Kyushu Medical Center, Fukuoka, Japan (M.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7613-8717","authenticated-orcid":true,"given":"Hirofumi","family":"Maruyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2184-0597","authenticated-orcid":true,"given":"Satoshi","family":"Teramukai","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Japan (S.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Kimura","sequence":"additional","affiliation":[{"name":"Primary Medical Science Department, Daiichi Sankyo, Tokyo, Japan (T.K., Y.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5062-1134","authenticated-orcid":true,"given":"Yoshiyuki","family":"Morishima","sequence":"additional","affiliation":[{"name":"Primary Medical Science Department, Daiichi Sankyo, Tokyo, Japan (T.K., Y.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Takita","sequence":"additional","affiliation":[{"name":"Data Intelligence Department, Daiichi Sankyo Co., Ltd., Tokyo, Japan (A.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8611-4994","authenticated-orcid":true,"given":"Takenori","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Medicine (K.T., T. 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