Oral Anticoagulation in Asian Patients With Atrial Fibrillation and a History of Intracranial Hemorrhage
DC Field | Value | Language |
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dc.contributor.author | Lee, So-Ryoung | - |
dc.contributor.author | Choi, Eue-Keun | - |
dc.contributor.author | Kwon, Soonil | - |
dc.contributor.author | Jung, Jin-Hyung | - |
dc.contributor.author | Han, Kyung-Do | - |
dc.contributor.author | Cha, Myung-Jin | - |
dc.contributor.author | Oh, Seil | - |
dc.contributor.author | Lip, Gregory Y. H. | - |
dc.date.available | 2020-09-14T08:06:32Z | - |
dc.date.created | 2020-06-17 | - |
dc.date.issued | 2020-02 | - |
dc.identifier.issn | 0039-2499 | - |
dc.identifier.uri | http://scholarworks.bwise.kr/ssu/handle/2018.sw.ssu/38778 | - |
dc.description.abstract | Background and Purpose-Warfarin is associated with a better net clinical benefit compared with no treatment in patients with nonvalvular atrial fibrillation (AF) and history of intracranial hemorrhage (ICH). There are limited data on nonvitamin K antagonist oral anticoagulants (NOACs) in these patients, especially in the Asian population. We aimed to compare the effectiveness and safety of NOACs to warfarin in a large-scale nationwide Asian population with AF and a history of ICH. Methods-Using the Korean Health Insurance Review and Assessment database from January 2010 to April 2018, we identified patients with oral anticoagulant naive nonvalvular AF with a prior spontaneous ICH. For the comparisons, warfarin and NOAC groups were balanced using propensity score weighting. Ischemic stroke, ICH, composite outcome (ischemic stroke+ICH), fatal ischemic stroke, fatal ICH, death from composite outcome, and all-cause death were evaluated as clinical outcomes. Results-Among 5712 patients with AF with prior ICH, 2434 were treated with warfarin and 3278 were treated with NOAC. Baseline characteristics were well-balanced after propensity score weighting (mean age 72.5 years and CHA(2)DS(2)-VASc score 4.0). Compared with warfarin, NOAC was associated with lower risks of ischemic stroke (hazard ratio [HR], 0.77 [95% CI, 0.61-0.97]), ICH (HR, 0.66 [95% CI, 0.47-0.92]), and composite outcome (HR, 0.73 [95% CI, 0.60-0.88]). NOAC was associated with lower risks of fatal stroke (HR, 0.54 [95% CI, 0.32-0.89]), death from composite outcome (HR, 0.53 [95% CI, 0.34-0.81]), and all-cause death (HR, 0.83 [95% CI, 0.69-0.99]) than warfarin. NOAC showed nonsignificant trends toward to reduce fatal ICH compared with warfarin (HR, 0.47 [95% CI, 0.20-1.03]). Conclusions-NOAC was associated with a significant lower risk of ICH and ischemic stroke compared with warfarin. NOAC might be a more effective and safer treatment option for Asian patients with nonvalvular AF and a prior history of ICH. | - |
dc.language | 영어 | - |
dc.language.iso | en | - |
dc.publisher | LIPPINCOTT WILLIAMS & WILKINS | - |
dc.relation.isPartOf | STROKE | - |
dc.title | Oral Anticoagulation in Asian Patients With Atrial Fibrillation and a History of Intracranial Hemorrhage | - |
dc.type | Article | - |
dc.identifier.doi | 10.1161/STROKEAHA.119.028030 | - |
dc.type.rims | ART | - |
dc.identifier.bibliographicCitation | STROKE, v.51, no.2, pp.416 - 423 | - |
dc.description.journalClass | 1 | - |
dc.identifier.wosid | 000527003000032 | - |
dc.citation.endPage | 423 | - |
dc.citation.number | 2 | - |
dc.citation.startPage | 416 | - |
dc.citation.title | STROKE | - |
dc.citation.volume | 51 | - |
dc.contributor.affiliatedAuthor | Han, Kyung-Do | - |
dc.type.docType | Article | - |
dc.description.isOpenAccess | N | - |
dc.subject.keywordAuthor | atrial fibrillation | - |
dc.subject.keywordAuthor | intracranial hemorrhages | - |
dc.subject.keywordAuthor | non-vitamin K antagonist oral anticoagulant | - |
dc.subject.keywordAuthor | oral anticoagulation | - |
dc.subject.keywordAuthor | stroke | - |
dc.subject.keywordAuthor | warfarin | - |
dc.subject.keywordPlus | TRANSIENT ISCHEMIC ATTACK | - |
dc.subject.keywordPlus | VITAMIN-K ANTAGONIST | - |
dc.subject.keywordPlus | INTRACEREBRAL HEMORRHAGE | - |
dc.subject.keywordPlus | STROKE PREVENTION | - |
dc.subject.keywordPlus | ANTITHROMBOTIC TREATMENT | - |
dc.subject.keywordPlus | MICROBLEEDS | - |
dc.subject.keywordPlus | GUIDELINES | - |
dc.subject.keywordPlus | WARFARIN | - |
dc.subject.keywordPlus | THERAPY | - |
dc.subject.keywordPlus | SAFETY | - |
dc.relation.journalResearchArea | Neurosciences & Neurology | - |
dc.relation.journalResearchArea | Cardiovascular System & Cardiology | - |
dc.relation.journalWebOfScienceCategory | Clinical Neurology | - |
dc.relation.journalWebOfScienceCategory | Peripheral Vascular Disease | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
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