Full Length ArticleIschemic stroke rates decline in patients with atrial fibrillation as anticoagulants uptake improves: A Swedish cohort study

- Impact of anticoagulants uptake on incidence of ischemic stroke is largely unknown.
- Population-based study of 11,500 adults diagnosed with atrial fibrillation 2011-2013
- Anticoagulants use increased from 36.6% to 48.4%.
- Cumulative incidence of stroke decreased from 2.87% to 1.93%.
- Increased use of anticoagulants is associated with decreased incidence of stroke.

IntroductionThe impact of the increased anticoagulants uptake on incidence rate of ischemic stroke is largely unknown. We assessed time trends in rates of ischemic stroke in patients with incident atrial fibrillation (AF) diagnosed between 2011 and 2013.Materials and methodsPopulation-based retrospective registry study of all 11,500 adults diagnosed with incident non-valvular atrial fibrillation in 2011-2013 in primary and secondary care and receiving oral anticoagulants (n = 4847), aspirin (n = 2850) or no treatment (n = 3766) in Skåne County, Sweden. The primary outcome was the rate of ischemic stroke within 365 days after AF diagnosis.Results and conclusionCumulative incidence of ischemic stroke decreased from 2.87% (95% confidence interval (CI) 2.37-3.45%) to 1.93% (95% CI 1.54-2.41%) while the uptake of oral anticoagulants increased from 36.6% to 48.4% between 2011 and 2013 (regression coefficient − 0.08; 95% CI, − 0.09 to − 0.07, p < 0.001). The increased uptake of oral anticoagulants in the community is associated with decreased incidence of ischemic stroke in AF patients.