Please use this identifier to cite or link to this item: https://doi.org/10.1161/STROKEAHA.110.592907
Title: Cost efficiency of anticoagulation with warfarin to prevent stroke in medicare beneficiaries with nonvalvular atrial fibrillation
Authors: Mercaldi, C.J.
Ciarametaro, M.
Hahn, B.
Chalissery, G.
Reynolds, M.W.
Sander, S.D.
Samsa, G.P.
Matchar, D.B. 
Keywords: Atrial fibrillation
Hemorrhage
Hemorrhagic
Ischemic
Stroke
Warfarin
Issue Date: Jan-2011
Citation: Mercaldi, C.J., Ciarametaro, M., Hahn, B., Chalissery, G., Reynolds, M.W., Sander, S.D., Samsa, G.P., Matchar, D.B. (2011-01). Cost efficiency of anticoagulation with warfarin to prevent stroke in medicare beneficiaries with nonvalvular atrial fibrillation. Stroke 42 (1) : 112-118. ScholarBank@NUS Repository. https://doi.org/10.1161/STROKEAHA.110.592907
Abstract: Background and Purpose-In controlled trials, anticoagulation with warfarin reduces stroke risk by nearly two thirds, but the benefit has been less pronounced in clinical practice. This report describes the extent of warfarin use, its effectiveness, and its impact on medical costs among Medicare patients with nonvalvular atrial fibrillation. Methods-Using claims from >2 million beneficiaries in the Centers for Medicare and Medicaid Services 5% Sample Standard Analytic Files, we identified patients with nonvalvular atrial fibrillation from 2004 to 2005. Warfarin use was inferred from 3 or more tests of the international normalized ratio within 1 year. Incidence of ischemic/hemorrhagic stroke and major bleeding was evaluated. Adjusted risk was calculated by Cox proportional-hazards regression. Medical costs (reimbursed amounts in 2006 US dollars) were estimated by multivariate linear regression. Results-Of patients with nonvalvular atrial fibrillation (N=119 764, mean age=79.3 years), 58.5% were categorized as warfarin users based on the study definition. During an average of 2.1 years' follow-up, the rate of ischemic stroke was 3.9 per 100 patient-years. After multivariate adjustment, ischemic stroke incidence was 27% lower in patients taking warfarin than in patients not taking warfarin (P
Source Title: Stroke
URI: http://scholarbank.nus.edu.sg/handle/10635/109994
ISSN: 00392499
DOI: 10.1161/STROKEAHA.110.592907
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