XXXX or @entity5069 and @entity64 : a Danish population-based study of the effectiveness of oral anticoagulation in clinical practice.

@entity1 @entity64 @entity548 @entity6 @entity955 @entity65 @entity204 @entity5069
OBJECTIVES: A pooled analysis of randomized trials has shown that oral anticoagulation therapy reduces the risk of @entity64 with 68% in @entity1 with @entity955 . We examined the effectiveness of oral anticoagulation on risk of @entity64 of any nature (fatal and nonfatal ischaemic and/or @entity548 ) in @entity1 with nonvalvular @entity955 or @entity5069 living in the County of North Jutland, Denmark. DESIGN: Cohort study. SUBJECTS AND METHODS: We used the Hospital Discharge Registry covering the county (490 000 inhabitants) from 1991 to 1998 to identify 2699 @entity1 and 2425 @entity1 with @entity955 or @entity5069 , aged 60-89 years. Data on prescriptions of anticoagulation were obtained from the National Health Service. We defined use of oral anticoagulation as date of prescription or reiteration plus 90 days. @entity1 were followed in the County Hospital Discharge Registry until a diagnosis of @entity64 (fatal and nonfatal ischaemic and/or @entity548 ), emigration, @entity204 or the end of 1998. We used Cox regression analyses to estimate the relative risk of @entity64 associated with use of oral anticoagulation compared with no use, adjusted for age, @entity6 and underlying @entity65 . RESULTS: Eight hundred and thirty-eight of 2699 @entity1 (31%) and 552 of 2425 @entity1 (23%) with @entity955 had one or more recorded prescriptions of oral anticoagulation. The incidence rates of @entity64 were 31 per 1000 @entity1 -years of follow-up in @entity1 , and 30 per 1000 @entity1 -years of follow-up in @entity1 . The adjusted relative risks of @entity64 during anticoagulation were 0.6 [95% confidence interval (CI) 0.4-1.0] in @entity1 , and 1.0 (95% CI 0.7-1.6) in @entity1 compared with nonuse periods. CONCLUSIONS: The effectiveness of oral anticoagulation in clinical practice may be lesser than the efficacy of oral anticoagulation reported from randomized trials.
