https://scholars.lib.ntu.edu.tw/handle/123456789/532826
標題: | Risk of bleeding and stroke with oral anticoagulation and antiplatelet therapy in patients with atrial fibrillation in Taiwan: A nationwide cohort study | 作者: | Chen P.-C. Lip G.Y.H. Yeh G. HUNG-JU LIN KUO-LIONG CHIEN |
公開日期: | 2015 | 出版社: | Public Library of Science | 卷: | 10 | 期: | 4 | 來源出版物: | PLoS ONE | 摘要: | Background Data on the use of oral anticoagulation (OAC) and antiplatelet therapy and the risk of bleeding and stroke amongst Asian patients with atrial fibrillation (AF) are limited. We investigated the risks of bleeding and stroke with use of oral anticoagulation (OAC) and antiplatelet therapy as mono- or combination therapy, in patients with AF from a Chinese nationwide cohort study. Methods We studied a cohort of 10384 patients (57.2% men, age 67.8 ± 13.2 yrs) between 1999 and 2010 from the National Health Insurance Research Database in Taiwan. Records of prescriptions were obtained during follow-up. The main outcome was a recurrent stroke during the follow-up period. Time-dependent Cox proportional hazards models were used for this analysis. Results We documented 1009 events for bleeding, as well as 224 hemorrhagic stroke and 1642 ischemic stroke events during a median 3.2 (interquartile range, 1.05-6.54) years' follow-up. Compared with warfarin users, patients with antiplatelet therapy had a lower risk of bleeding (adjusted relative risk [RR], 0.59, 95% confidence interval [CI], 0.49-0.71, p<0.001) whilst combination therapy had a non-statistically significant higher bleeding risk (RR, 1.33, 95%, 0.91-1.94, p = 0.20). Patients on antiplatelet monotherapy had a similar risk for ischemic stroke compared with OAC (RR 1.05, 95% CI, 0.89-1.25, p = 0.50), whilst those on combination therapy had a significantly higher risk (RR 1.90, 95% CI, 1.34-2.70, p<0.001). ? 2015 Chen et al. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84928795012&doi=10.1371%2fjournal.pone.0125257&partnerID=40&md5=3ca377c8dcee229680d2e390affed04a https://scholars.lib.ntu.edu.tw/handle/123456789/532826 |
ISSN: | 1932-6203 | DOI: | 10.1371/journal.pone.0125257 | SDG/關鍵字: | acetylsalicylic acid; amiodarone; anticoagulant agent; antithrombocytic agent; clopidogrel; propafenone; sotalol; warfarin; anticoagulant agent; antithrombocytic agent; age distribution; aged; Article; atrial fibrillation; bleeding; brain hemorrhage; brain ischemia; cardiovascular risk; Chinese; cohort analysis; controlled study; female; follow up; human; major clinical study; male; medical documentation; medical record; monotherapy; national health insurance; prescription; sex ratio; Taiwan; treatment outcome; atrial fibrillation; chemically induced; factual database; Hemorrhage; middle aged; oral drug administration; retrospective study; Stroke; very elderly; Administration, Oral; Aged; Aged, 80 and over; Anticoagulants; Atrial Fibrillation; Databases, Factual; Hemorrhage; Humans; Male; Middle Aged; Platelet Aggregation Inhibitors; Retrospective Studies; Stroke; Taiwan |
顯示於: | 醫學系 |
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