Highlights
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Excessive alcohol use is the strongest risk factor of iTTR < 60 %.
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Patients with previous stroke are more likely to get iTTR > 70 %.
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Patients with other comorbidities are more likely to get iTTR < 60 %.
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The SAMe-TT2R2 score does not apply.
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Instead of warfarin, DOACs could perhaps be the anticoagulant of choice, when treating patients with strong risk factors such as excessive alcohol use.
Introduction
Methods and material
Cause of death register
Swedish National Patient Register
Statistical methods
Results
Baseline variables | Total | iTTR < 60% | iTTR ≥ 70% |
---|---|---|---|
n = 28,011 | n = 7835 | n = 15,707 | |
Age, mean year (SD) | 73.7 (± 9.5) | 72.9 (± 10.4) | 74.2 (± 8.9) |
Male | 16,261 (58.0) | 4674 (59.7) | 9003 (57.3) |
Female | 11,750 (42.0) | 3161 (40.3) | 6704 (42.7) |
Stroke | 5396 (19.3) | 1341 (17.1) | 3188 (20.3) |
TIA | 2205 (7.9) | 540 (6.9) | 1326 (8.4) |
Hypertension | 16,739 (59.8) | 4973 (63.5) | 9120 (58.1) |
Chronic heart failure | 7989 (28.5) | 2500 (31.9) | 4085 (26.0) |
Diabetes mellitus | 4978 (17.8) | 1668 (21.3) | 2481 (15.8) |
Myocardial infarction | 6030 (21.5) | 1795 (22.9) | 3256 (20.7) |
Cancer | 3292 (11.8) | 1006 (12.8) | 1754 (11.2) |
Chronic obstructive pulmonary disease | 2485 (8.9) | 921 (11.8) | 1120 (7.1) |
Renal failure | 1087 (3.9) | 441 (5.6) | 447 (2.9) |
Excessive alcohol use | 539 (1.9) | 292 (3.7) | 165 (1.1) |
Dementia | 133 (0.5) | 48 (0.6) | 65 (0.4) |
Liver disease | 239 (0.9) | 100 (1.3) | 105 (0.7) |
History of fall | 2227 (8.0) | 664 (8.5) | 1195 (7.6) |
Anemia | 1922 (6.9) | 691 (8.8) | 896 (5.7) |
Previous major bleeding | 1777 (6.3) | 557 (7.1) | 916 (5.8) |
Previous gastrointestinal bleeding | 931 (3.3) | 286 (3.7) | 484 (3.1) |
Previous intracranial bleeding | 403 (1.4) | 130 (1.7) | 208 (1.3) |
CHA2DS2-VASc score, mean (SD) | 3.6 (± 1.7) | 3.6 (± 1.8) | 3.6 (± 1.6) |
All n = 28,011 | iTTR < 60% n = 7835 | iTTR ≥ 70% n = 15,707 | ||||
---|---|---|---|---|---|---|
n | % (CI 95%) | n | % (CI 95%) | n | % (CI 95%) | |
All-cause mortality | 1191 | 2.63 (2.48–2.80) | 436 | 7.33 (6.63–8.03) | 518 | 1.60 (1.46–1.74) |
Any major bleeding | 1152 | 2.55 (2.40–2.70) | 325 | 5.46 (4.86–6.07) | 593 | 1.83 (1.68–1.98) |
Intracranial | 223 | 0.49 (0.43–0.56) | 53 | 0.89 (0.65–1.14) | 125 | 0.39 (0.32–0.46) |
Gastrointestinal | 393 | 0.87 (0.79–0.96) | 119 | 2.02 (1.65–2.39) | 206 | 0.64 (0.55–0.73) |
Other | 630 | 1.41 (1.30–1.53) | 183 | 3.16 (2.69–3.63) | 313 | 0.98 (0.87–1.09) |
Any thromboembolism | 1578 | 3.49 (3.31–3.66) | 405 | 6.81 (6.13–7.49) | 910 | 2.81 (2.62–2.99) |
Arterial | 899 | 2.05 (1.91–2.18) | 220 | 3.82 (3.30–4.33) | 536 | 1.70 (1.56–1.85) |
Myocardial infarction | 662 | 1.49 (1.37–1.61) | 170 | 2.92 (2.47–3.37) | 371 | 1.16 (1.04–1.29) |
Venous | 66 | 0.15 (0.11–0.18) | 25 | 0.42 (0.25–0.59) | 31 | 0.10 (0.06–0.13) |
OR | 95% CI for OR | p | |
---|---|---|---|
Age | 0.99 | 0.98–0.99 | < 0.001 |
Female sex | 0.98 | 0.93–1.04 | 0.481 |
Stroke | 0.85 | 0.79–0.91 | < 0.001 |
TIA | 0.91 | 0.82–1.00 | 0.056 |
Hypertension | 1.25 | 1.18–1.32 | < 0.001 |
Diabetes mellitus | 1.25 | 1.16–1.33 | < 0.001 |
Myocardial infarction | 1.07 | 1.00–1.14 | 0.045 |
Cancer | 1.21 | 1.11–1.31 | < 0.001 |
Chronic obstructive pulmonary disease | 1.45 | 1.33–1.59 | < 0.001 |
Renal failure | 1.47 | 1.29–1.68 | < 0.001 |
Excessive alcohol use | 2.72 | 2.27–3.24 | < 0.001 |
Dementia | 1.47 | 1.02–2.12 | 0.038 |
Liver disease | 1.27 | 0.97–1.67 | 0.083 |
History of fall | 1.23 | 1.11–1.35 | < 0.001 |
Anemia | 1.36 | 1.22–1.51 | < 0.001 |
Previous major bleeding | 1.00 | 0.85–1.16 | 0.971 |
Previous gastrointestinal bleeding | 0.99 | 0.82–1.20 | 0.905 |
Previous intracranial bleeding | 1.21 | 0.95–1.55 | 0.116 |
OR | 95% CI for OR | p | |
---|---|---|---|
Age | 1.01 | 1.01–1.02 | < 0.001 |
Female sex | 0.99 | 0.95–1.05 | 0.826 |
Stroke | 1.11 | 1.04–1.18 | 0.001 |
TIA | 1.09 | 1.00–1.19 | 0.062 |
Hypertension | 0.85 | 0.81–0.89 | < 0.001 |
Chronic heart failure | 0.80 | 0.76–0.84 | < 0.001 |
Diabetes mellitus | 0.81 | 0.76–0.86 | < 0.001 |
Myocardial infarction | 0.94 | 0.89–1.00 | 0.049 |
Cancer | 0.84 | 0.78–0.91 | < 0.001 |
Chronic obstructive pulmonary disease | 0.67 | 0.62–0.73 | < 0.001 |
Renal failure | 0.65 | 0.58–0.74 | < 0.001 |
Excessive alcohol use | 0.39 | 0.32–0.47 | < 0.001 |
Liver disease | 0.87 | 0.66–1.14 | 0.308 |
History of fall | 0.81 | 0.74–0.89 | < 0.001 |
Anemia | 0.74 | 0.67–0.82 | <0.001 |
Previous major bleeding | 0.97 | 0.84–1.12 | 0.699 |
Previous gastrointestinal bleeding | 0.99 | 0.83–1.18 | 0.924 |
Previous intracranial bleeding | 0.86 | 0.69–1.08 | 0.194 |