title: Use of oral anticoagulation among stroke patients with atrial fibrillation in China: the ChinaQUEST (Quality evaluation of stroke care and treatment) registry study.
abstract: BACKGROUND
  International guidelines recommend oral anticoagulation in patients with atrial fibrillation according to their level of stroke risk. This study aimed to determine oral anticoagulation use in atrial fibrillation patients with recent ischemic stroke and examine factors that impact such management in China.
  
  
  METHODS
  Among the patients with acute ischemic stroke (n = 4782) from the China QUality Evaluation of Stroke Care and Treatment study, a multicenter, prospective, 62-hospital registry in China, there were 499 (10%) (mean age 70 ± 12 years, 49% female) with documented atrial fibrillation with outcome data over 12 months of follow-up. Logistic regression analysis was used to identify the independent predictors of oral anticoagulation use in these patients.
  
  
  RESULTS
  Of the 499 stroke patients with atrial fibrillation, oral anticoagulation use was 20% overall but varied from 8% prestroke and 11% in-hospital (poststroke), to 13% and 10% at three-months and 12 months, respectively. Oral anticoagulation use was independently associated with younger age (odds ratio 0.95, 95% confidence interval 0.93-0.97, P < 0.001), nonmanual occupation (odds ratio 0.44, 95% confidence interval 0.25-0.80, P = 0.006), and less cardiovascular risk factors (odds ratio 0.81, 95% confidence interval 0.68-0.96, P = 0.02).
  
  
  CONCLUSIONS
  These data indicate oral anticoagulation use is lower in stroke patients with atrial fibrillation in China than that in Western countries, being applied more often in those of younger age, nonmanual occupation, and having less cardiovascular risk factors.
authors.affiliation: Institute of Neurosciences, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
authors.forename: Qingchun
authors.initials: Q
authors.lastname: Gao
authors.forename: Xian
authors.initials: X
authors.lastname: Fu
authors.forename: Jade W
authors.initials: JW
authors.lastname: Wei
authors.forename: Xiangyan
authors.initials: X
authors.lastname: Chen
authors.forename: Yining
authors.initials: Y
authors.lastname: Huang
authors.forename: Jiguang
authors.initials: J
authors.lastname: Wang
authors.forename: Craig S
authors.initials: CS
authors.lastname: Anderson
authors.forename: Ka Sing
authors.initials: KS
authors.lastname: Wong
mesh_terms: D000284:Administration, Oral; D000367:Age Factors; D000925:Anticoagulants / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy*; D002545:Brain Ischemia / Q000517:prevention & control*; D002681:China; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D020521:Stroke / Q000517:prevention & control*; D014859:Warfarin / Q000008:administration & dosage*
chemical_list: D000925:Anticoagulants; D014859:Warfarin