Warfarin use following ischemic stroke among Medicare patients with atrial fibrillation.

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Abstract
OVER THE PAST decade, great advances have been made in stroke prevention.1,2 Among the most potent therapies for stroke prevention is the use of anticoagulation therapy for patients with atrial fibrillation. Atrial fibrillation is a common cause of stroke accounting for 10% to 15% of all ischemic strokes and nearly a quarter of strokes for those older than 80 years.3 Primary prevention of stroke in patients with atrial fibrillation is of particular importance since these strokes appear to be more severe and the outcome markedly poorer than in patients with a sinus rhythm.4,5 The rate of death or significant neurologic disability is as high as 71%.5,6 Among appropriate patients with atrial fibrillation, anticoagulation can reduce the risk of a first stroke by about 68%7 and is the recommended therapy in published guidelines.8-11