|Title:||Do Patients With High CHA2DS2-VASc Scores Need High Intensity of Anticoagulants After Valve Surgery?||Authors:||HSI-YU YU 虞希禹
LIAN-YU LIN 林亮宇
CHIH-HSIEN WANG 王植賢
NAI-HSIN CHI 紀乃新
|Keywords:||Anticoagulation; Chinese; Follow-up study; Valve surgery; Warfarin||Issue Date:||Mar-2018||Publisher:||JAPANESE CIRCULATION SOC||Journal Volume:||82||Journal Issue:||4||Start page/Pages:||1186||Source:||Circulation journal : official journal of the Japanese Circulation Society||Abstract:||
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 CHA2DS2-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) CHA2DS2-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).
|Appears in Collections:||醫學系|
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