https://scholars.lib.ntu.edu.tw/handle/123456789/433955
標題: | Do patients with high CHA 2 DS 2 -VASC scores need high intensity of anticoagulants after valve surgery? | 作者: | HSI-YU YU Lin M.-H. LIAN-YU LIN CHIH-HSIEN WANG NAI-HSIN CHI YIH-SHARNG CHEN |
公開日期: | 2018 | 出版社: | Japanese Circulation Society | 卷: | 82 | 期: | 4 | 起(迄)頁: | 1186-1194 | 來源出版物: | Circulation Journal | 摘要: | Background: Asian patients on warfarin therapy usually have lower international normalized ratio (INR) intensities than those recommended by Western clinical practice guidelines. This study evaluated whether a high INR reduces the incidence of thromboembolism (TE) or bleeding events in Asian patients with high CHA 2 DS 2 -VASc scores after valve surgery. Methods and Results: Data of adult patients after valve surgery were retrieved from an integrated healthcare information system of a single hospital between 2014 and 2016. The INR was derived from the closest laboratory data before the index outpatient-clinic visit date. The endpoint of every record was determined as emergency room visit or hospitalization because of TE or bleeding event. A total of 37 TE or bleeding events were retrieved from 8,207 records; the annual incidence rate were 1.2% and 2.8% for low (0–2) and high (3–8) CHA 2 DS 2 -VASc score groups, respectively (P=0.007). The incidence rates were lowest for both groups at an INR of 1.5–2.0. High INR intensities did not reduce TE or bleeding incidence. INR >3.0 was associated with increased TE or bleeding incidence in the high-score group (6.8%/year vs. 2.0%/year, P=0.079). Conclusions: The optimal INR is 1.5–2.5 for low- or high-score Asian patients after valve surgery. INR >3.0 was associated with increased TE or bleeding incidence in the high-score group. ? 2018, Japanese Circulation Society. All rights reserved. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85044259800&doi=10.1253%2fcircj.CJ-17-1172&partnerID=40&md5=4d8c1fe20a92a6e7f5593ee5dad4923f https://scholars.lib.ntu.edu.tw/handle/123456789/433955 |
ISSN: | 1346-9843 | DOI: | 10.1253/circj.CJ-17-1172 | SDG/關鍵字: | anticoagulant agent; warfarin; anticoagulant agent; adult; aged; Article; bleeding; brain ischemia; CHA2DS2-VASc score; diabetes mellitus; female; health care system; heart valve surgery; hospitalization; human; hypertension; ICD-9; incidence; major clinical study; male; middle aged; risk factor; thromboembolism; xenograft; Asian continental ancestry group; bleeding; heart valve; international normalized ratio; postoperative care; procedures; retrospective study; risk assessment; standards; surgery; thromboembolism; very elderly; Aged; Aged, 80 and over; Anticoagulants; Asian Continental Ancestry Group; Female; Heart Valves; Hemorrhage; Humans; Incidence; International Normalized Ratio; Male; Middle Aged; Postoperative Care; Retrospective Studies; Risk Assessment; Thromboembolism; Warfarin |
顯示於: | 醫學系 |
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