Table 3.
Risk of stroke outcomes in NOAC, aspirin and mixed users compared with VKA users
| Outcome | Number of events | Incidence rate per 1000 person‐years | Age/sex adjusted hazard ratio (95% CI) | Adjusted hazard ratio (95% CI) * |
|---|---|---|---|---|
| Stroke | ||||
| Current (≤30 days before index date) | ||||
| VKA only use | 181 | 6.72 | Reference | Reference |
| NOAC only use | 15 | 8.81 | 1.37 (0.81–2.33) | 1.38 (0.81–2.35) |
| Aspirin only use | 342 | 17.85 | 1.99 (1.69–2.36) | 2.03 (1.72–2.39) |
| Mixed use | 16 | 15.62 | 1.98 (1.19–3.29) | 2.04 (1.23–3.39) |
| Past (>30 days) | ||||
| VKA use | 195 | 10.15 | 1.11 (0.93–1.32) | 1.10 (0.92–1.31) |
| NOAC use | 8 | 10.36 | 1.37 (0.68–2.78) | 1.37 (0.68–2.78) |
| Aspirin use | 276 | 12.19 | 1.53 (1.29–1.81) | 1.54 (1.30–1.82) |
| Haemorrhagic stroke | ||||
| Current (≤30 days before index date) | ||||
| VKA only use | 57 | 1.92 | Reference | Reference |
| NOAC only use | 5 | 2.53 | 1.54 (0.60–3.93) | 1.56 (0.61–3.99) |
| Aspirin only use | 38 | 1.91 | 0.87 (0.58–1.31) | 0.87 (0.58–1.31) |
| Mixed use | <5 | ** | 0.94 (0.23–3.84) | 0.95 (0.23–3.89) |
| Past (>30 days before index date) | ||||
| VKA use | 49 | 2.37 | 1.37 (0.95–1.97) | 1.37 (0.95–1.97) |
| NOAC use | <5 | ** | 1.50 (0.36–6.18) | 1.50 (0.36–6.18) |
| Aspirin use | 47 | 1.97 | 0.89 (0.62–1.30) | 0.89 (0.62–1.29) |
| Ischaemic stroke | ||||
| Current (≤30 days before index date) | ||||
| VKA only use | 156 | 5.76 | Reference | Reference |
| NOAC only use | 12 | 7.00 | 1.20 (0.67–2.17) | 1.22 (0.67–2.19) |
| Aspirin only use | 327 | 16.95 | 2.13 (1.79–2.54) | 2.18 (1.83–2.59) |
| Mixed use | 15 | 14.58 | 2.09 (1.24–3.53) | 2.16 (1.28–3.64) |
| Past (>30 days befor index date) | ||||
| VKA use | 170 | 8.79 | 1.04 (0.86–1.26) | 1.03 (0.86–1.25) |
| NOAC use | 6 | 7.68 | 1.10 (0.49–2.49) | 1.10 (0.49–2.48) |
| Aspirin use | 256 | 11.22 | 1.63 (1.37–1.95) | 1.65 (1.38–1.97) |
CI, confidence interval VKA, vitamin K antagonist; NOAC, nonvitamin K antagonist oral anticoagulant; ACE, angiotensin converting enzyme; ATII, angiotensin II; NSAIDs, nonsteroidal anti‐inflammatory drugs; SSRIs, selective serotonin reuptake inhibitors.
*Adjusted for age, sex, body mass index, alcohol status, smoking status, antidiabetics, ACE‐inhibitors, antiplatelets, ATII antagonists, calcium channel blockers, cerebrovascular disease, hypertension, peripheral artery disease, statins.
**
Suppressed due to fewer than five patients (ISAC regulations).