ABC | Volume 114, Nº4, April 2020

Viewpoint Ferreira et al. Anticoagulant Search Trends and Stroke Arq Bras Cardiol. 2020; 114(4):726-729 Figure 1 – Annual ischemic stroke-related deaths and mean Google Trends scores for anticoagulants. After 2011, an increase in the online popularity of rivaroxaban was accompanied by a decrease in the number of ischemic stroke related-deaths in Brazil. 51000 50000 49000 48000 47000 46000 45000 Deaths Google Trends score 44000 43000 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Ischemic and unspecified strokes Warfarin Rivaroxaban Dabigatran 0 10 20 30 40 50 60 70 80 42000 Figure 2 – Annual hemorrhagic stroke-related deaths and mean anticoagulant Google Trends scores. After 2011, an increase in rivaroxaban’s online popularity was accompanied by an escalation in the total number of hemorrhagic stroke related-deaths in Brazil. Google Trends score Hemorrhagic strokes Warfarin Rivaroxaban Dabigatran 0 10 20 30 40 50 60 70 80 2006 18500 19500 20500 21500 19000 20000 Deaths 21000 22000 2007 2008 2009 2010 2011 2012 2013 2014 2015 appraisal of the collected data is also of upmost importance. Over the last 10 years, the increasing clinical experience with DOACs in patients with AF has been accompanied by a significant global rise in the popularity of these drugs in Internet search engines. This phenomenon also appears to be occurring in middle-income countries, such as Brazil. However, the association between web-based tendencies and clinical outcomes is still an area that needs further investigation. There is a possibility that the effectiveness of large-scale health care policies and interventions, such as vaccination campaigns, may be monitored by online search data, especially in regions where most of the population 728