Version FINAL rev 140813
Electronic Supplementary Material
All / Warfarin / Aspirin / No treatment*n / 41810 / 15680 / 14236 / 9959
Clopidogrel / 2,0% / 0,3% / 2,5% / 0,0%
Low molecular weight heparin / 3,3% / 4,1% / 2,1% / 3,1%
Antihypertensive or antianginal drugs / 85,9% / 94,7% / 92,2% / 60,8%
Lipid-lowering drugs / 31,7% / 40,3% / 31,8% / 14,1%
Insulin / 5,9% / 6,2% / 6,7% / 3,9%
Oral antidiabetic drugs / 8,3% / 10,6% / 8,1% / 4,1%
*clopidogrel excluded
Supplementary Table 1 – Other drug treatment among 41 810 atrial fibrillation patients in the Stockholm County Council.
Supplementary Figure 1 – Factors contributing to CHA2DS2VASc scores 1 and 2 in 9 032 AF patients with warfarin, aspirin or no treatment*.
*clopidogrel excluded
Supplementary Figure 2 –Risks of suffering ischemic (IS) and hemorrhagic stroke (HS) during 2010 in 41810 AF patients, warfarin vs. no warfarin (i.e. aspirin or no treatment according to [3]). Patients who had claimed prescriptions of both warfarin and aspirin are included in the warfarin group.
The patients having claimed both warfarin and aspirin between between July 1st 2009 and Dec 31st 2009 (n=1574) represented 3.8% of the total atrial fibrillation cohort. They were younger than the patients in the warfarin and aspirin groups: their mean age was 72.3 years and 71.1 % were under the age of 80. The majority were men (63.0%). The mean CHA2DS2VASc score was 4.0 and 47.9% had vascular disease, which was more common than in the other treatment groups. Also, diabetes (24.5%) and hypertension (72.2%) were slightly more common. Other co-morbidity was similar to the warfarin treated patients, while clopidogrel (5.8%) and lipid lowering treatment (53.2%) were more common.
Their risk of suffering ischemic stroke was 5.2%, thromboembolism 7.2%, hemorrhagic stroke 0.8%, traumatic intracranial bleeding 0.3%, any severe bleed 3.4%, and death 9.0%
Supplementary Text – Characteristics and Outcomes of 1574 AF Patients Claiming both Warfarin and Aspirin
Alcohol abuse / E244, F10, G312, G621, G721, I426, K292, K70, K860, O354, P043, Q860, T51, Y90-91, Z502, Z714
Anemia / D50-64
Any severe bleed / I60-62, I690-I692,, S064-S066, I850, I983, K25-28 (subcodes 0-2 and 4-6 only), K625, K922, D629
Atrial fibrillation / I48
Cancer / entire C-series
Cardioversion / Procedure codes DF026, DF027
COPD/Emphysema / J43-44
Dementia / F00-F03
Diabetes / E10-E14
Frequent falls (more than one registration) / W00-19
Gastric duadenal bleeding / K25-28 (subcodes 0-2 and 4-6 only)
Heart failure / I50
Hypertension / I10-I15
Ischemic stroke, arterial embolism, and stroke, unspecified / I63, I64, I679, I693, I694, I698, I67-, I69-, Z866, Z867, G450, G451, G452, G453, G458, G45.9, G45-, I74
Intracranial bleeding / I60-I62, I690-I692, S064-S066
Liver disease / K70-77
Mechanical valve / Procedure codes FCA60, FCA70, FDC10, FGE00, FGE10, FGE20, FGE96, FJF00, FJF10, FJF12, FJF20, FJF96, FKD00, FKD10, FKD20, FKD96, FMD00, FMD10, FMD12, FMD13, FMD20, FMD30, FMD40, FMD96
Mitral stenosis / I050, I052, I342
Obesity / E65-66
Renal disease / N17-19
Vascular disease / I20-I25, I70, I739
Venous thromboembolism / I26, I80-I82
Outcomes
(only inpatient care or specialist ambulatory care)
Any severe bleed / I60-62, S064-S066, I850, I983, K25-28 (subcodes 0-2 and 4-6 only), K625, K922, D629
Intracranial bleeding / I60-I62, S064-S066
Ischemic stroke / I63
Hemorrhagic stroke / I60-I62
Thromboembolism / I63, I64, G450, G451, G452, G453, G458, G459, I74
Traumatic intracranial bleeding / S064-S066
Supplementary Appendix A - Definitions of co-morbidities and outcomes by ICD-10, primary care codes and procedure codes.
Treatment / ATC-code beginning withAcetylsalicylic acid (aspirin) / B01AC06
Antihypertensive drugs / C03, C07, C08, C09
Clopidogrel / B01AC04
Insulin / A10A
Lipid-lowering treatment / C10
Low molecular weight heparin / B01AB04, B01AB05
Oral antidiabetic treatment / A10B
Warfarin / B01AA
Supplementary Appendix B – ATC-codes of concomitant treatments.
1