Atrial fibrillation and stroke in the general medicare population - A 10-year perspective (1992 to 2002)
Atrial fibrillation and stroke in the general medicare population - A 10-year perspective (1992 to 2002)
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DOI：
10.1161/01.str.0000230607.07928.17
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发表时间：
2006-08-01
期刊：
影响因子：
8.3
通讯作者：
Herzog, Charles A.
中科院分区：
文献类型：
--
作者：
Lakshminarayan, Kamakshi;Solid, Craig A.;Herzog, Charles A.
背景和目的：临床试验表明华法林对房颤（AF）患者卒中风险有保护作用。目前的研究调查了1992年至2002年医疗保险患者房颤患病率、华法林使用及其与卒中风险的关系的时间趋势。方法：使用1992年至2002年5%的医疗保险样本，创建全年以医疗保险作为主要付款人的1年队列。国际疾病分类第九版临床修改代码用于识别房颤、缺血性和出血性卒中以及合并症。先前验证的替代测量，凝血酶原/国际标准化比率声明，用于确定华法林的使用。以华法林作为时间相关变量，采用Cox比例风险回归来检验卒中发生时间。结果：在65岁的医疗保险患者中，房颤患病率从1992年的3.2%上升到2002年的6.0%，研究人群中年龄较大的亚群患病率更高。在房颤患者中，华法林的使用明显增加(P
Background and Purpose-Clinical trials have illustrated warfarin's protective effect on stroke risk in patients with atrial fibrillation (AF). The current study investigated temporal trends in AF prevalence, warfarin use, and its relation to stroke risk in Medicare patients with AF from 1992 to 2002.Methods-The Medicare 5% sample for 1992 to 2002 was used to create 1-year cohorts of patients with Medicare as primary payer throughout the year. International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to identify AF, ischemic and hemorrhagic stroke, and comorbid conditions. A previously validated surrogate measure, prothrombin/international normalized ratio claims, was used to identify warfarin use. Cox proportional hazards regression was used to examine time to stroke with warfarin use as a time-dependent variable.Results-Among Medicare patients aged >= 65 years, AF prevalence increased from 3.2% in 1992 to 6.0% in 2002 with higher prevalence in older subsets of the study population. Among patients with AF, warfarin use increased significantly (P