1
|
Kim D. What Is a Balanced Way of Anticoagulation for Efficacy and Safety in High-Risk Elderly Patients With Atrial Fibrillation? Korean Circ J 2024; 54:407-408. [PMID: 39005073 PMCID: PMC11252632 DOI: 10.4070/kcj.2024.0170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 06/17/2024] [Indexed: 07/16/2024] Open
Affiliation(s)
- Daehoon Kim
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
| |
Collapse
|
2
|
Dongre K, Schmid Y, Nussbaum L, Winterhalder C, Bassetti S, Holbro A, Degen L, Leuppi-Taegtmeyer AB. Gastrointestinal bleeding during anticoagulation with direct oral anticoagulants compared to vitamin K antagonists. Glob Cardiol Sci Pract 2022; 2022:e202221. [PMID: 36660168 PMCID: PMC9840132 DOI: 10.21542/gcsp.2022.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 09/30/2022] [Indexed: 12/14/2022] Open
Abstract
Aim: Patients receiving oral anticoagulants with vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs) have an increased risk of gastrointestinal bleeding (GIB). We compared cases of GIB associated with VKAs and DOACs in terms of risk factors, scores, timing, location, severity, and outcome. Methods: Data from patients treated at a university hospital in Switzerland for GIB under VKA and DOACs between 2012 and 2018 were analyzed in this investigator-driven, retrospective, single-center study. Results: A total of 248 patients (110 males; median age, 80 years; 134 VKA, 114 DOAC) were included. No significant differences in age, weight or sex were observed. The propensity of the VKA group for risk factors such as comorbidities, interacting medications, or a high risk for bleeding (HAS-BLED score) was higher than that of the DOAC group. 56% of the VKA-treated patients had a supratherapeutic INR, and 25% in the DOAC group received an unlicensed dose. Significantly more patients in the DOAC group were not formally overdosed with OAC whilst receiving amiodarone compared to the VKA group (57% vs. 18%, respectively, p = 0.03). Latency between the documented start of oral anticoagulation and GIB was shorter in the DOAC group (median 3 months) than in the VKA group (median 23.5 months, p¡0.001). There were no differences in terms of location and severity of the GIB, length of hospitalization, or mortality. Conclusion: Patients taking VKAs displayed more risk factors for GIB than those taking DOACs. Treatment with DOACs was associated with early GIB and calls for increased vigilance during the first months after commencement. Co-medication with amiodarone appeared to be a risk factor for GIB in patients taking DOACs.
Collapse
Affiliation(s)
- Kanchan Dongre
- Department of Patient Safety, Medical Directorate, University Hospital Basel, Switzerland
| | - Yasmin Schmid
- Department of Clinical Pharmacology and Toxicology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Luana Nussbaum
- Department of Clinical Pharmacology and Toxicology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Clemens Winterhalder
- Division of Internal Medicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Stefano Bassetti
- Division of Internal Medicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Andreas Holbro
- Blood Transfusion Centre, Swiss Red Cross, Basel, Switzerland,Department of Hematology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Lukas Degen
- Clarunis, University Center for Gastrointestinal and Liver Diseases, Basel, Switzerland
| | - Anne B. Leuppi-Taegtmeyer
- Department of Patient Safety, Medical Directorate, University Hospital Basel, Switzerland,Department of Clinical Pharmacology and Toxicology, University Hospital Basel and University of Basel, Basel, Switzerland
| |
Collapse
|
3
|
Yuguero O, Cabello I, Arranz M, Guzman JA, Moreno A, Frances P, Santos J, Esquerrà A, Zarauza A, Mòdol JM, Jacob J. Emergency Department capacity to initiate thromboprophylaxis in patients with atrial fibrillation and thrombotic risk after discharge: URGFAICS cohort analysis. Intern Emerg Med 2022; 17:873-881. [PMID: 34677788 DOI: 10.1007/s11739-021-02864-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 09/28/2021] [Indexed: 11/24/2022]
Abstract
Atrial fibrillation (AF) is the most prevalent heart rhythm disorder in the general population. Stroke prevention is one of the leading management objectives in the treatment of AF patients. The variables associated with the non-initiation of thromboprophylaxis in patients with thrombotic risk consulting for an episode of AF in Emergency Departments (ED) were investigated. This was a multipurpose, analytical, non-interventionist, multicenter Spanish study with a prospective 30-day follow-up. All patients ≥ 18 years of age consulting to the ED for the casual finding of AF in an electrocardiogram (ECG) performed 12 h prior to the consultation or with symptoms related to AF were enrolled from September 1, 2016 to February 28, 2017. Patients not previously received thromboprophylaxis were selected. Multivariate analysis was performed to calculate the odds ratio (OR) and the 95% confidence interval (CI). A total of 634 patients, not received thromboprophylaxis and at high thrombotic risk, were included. Of these, 251 (39.6%) did not receive thromboprophylaxis at ED discharge. In the multivariate analysis, non-initiation of anticoagulation at discharge from the ED was mostly related to cognitive impairment (OR 3.95; (95% CI 2.02-7.72), cancer history (OR 2.12; (95%CI 1.18-3.81), AF duration < 48 h (OR 2.49; (95% CI 1.48-4.21) and patients with re-establishment of sinus rhythm (OR 3.65; (95% CI 1.47-9.06). Reinforcement of the use of CHA2DS2-VASC as a stroke risk scale and empowerment of ED physicians is a must to improve this gap in care.
Collapse
Affiliation(s)
- Oriol Yuguero
- Emergency Department, Hospital Arnau de Vilanova, Lleida, Spain
| | - Irene Cabello
- Emergency Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Feixa Llarga s/n. 08907, Barcelona, Spain.
| | - María Arranz
- Emergency Department, Hospital de Viladecans, Viladecans, Barcelona, Spain
| | | | - Anna Moreno
- Emergency Department, Hospital Arnau de Vilanova, Lleida, Spain
| | - Paloma Frances
- Emergency Department, Hospital Universitari Joan XXIII, Tarragona, Spain
| | - Julia Santos
- Emergency Department, Hospital de Viladecans, Viladecans, Barcelona, Spain
| | - Anna Esquerrà
- Emergency Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Alvaro Zarauza
- Emergency Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Feixa Llarga s/n. 08907, Barcelona, Spain
| | - Josep-Maria Mòdol
- Emergency Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Javier Jacob
- Emergency Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Feixa Llarga s/n. 08907, Barcelona, Spain
| |
Collapse
|
4
|
Müller M, Chanias I, Nagler M, Exadaktylos AK, Sauter TC. Falls in ED patients: do elderly patients on direct oral anticoagulants bleed less than those on vitamin K antagonists? Scand J Trauma Resusc Emerg Med 2021; 29:56. [PMID: 33823884 PMCID: PMC8022425 DOI: 10.1186/s13049-021-00866-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 03/09/2021] [Indexed: 11/23/2022] Open
Abstract
Background Falls from standing are common in the elderly and are associated with a significant risk of bleeding. We have compared the proportional incidence of bleeding complications in patients on either direct oral anticoagulants (DOAC) or vitamin K antagonists (VKA). Methods Our retrospective cohort study compared elderly patients (≥65 years) on DOAC or VKA oral anticoagulation who presented at the study site – a Swiss university emergency department (ED) – between 01.06.2012 and 01.07.2017 after a fall. The outcomes were the proportional incidence of any bleeding complication and its components (e.g. intracranial haemorrhage), as well as procedural and clinical parameters (length of hospital stay, admission to intensive care unit, in-hospital-mortality). Uni- and multivariable analyses were used to compare the studied outcomes. Results In total, 1447 anticoagulated patients were included – on either VKA (n = 1021) or DOAC (n = 426). There were relatively more bleeding complications in the VKA group (n = 237, 23.2%) than in the DOAC group (n = 69, 16.2%, p = 0.003). The difference persisted in multivariable analysis with 0.7-fold (95% CI: 0.5–0.9, p = 0.014) lower odds for patients under DOAC than under VKA for presenting with any bleeding complications, and 0.6-fold (95% 0.4–0.9, p = 0.013) lower odds for presenting with intracranial haemorrhage. There were no significant differences in the other studied outcomes. Conclusions Among elderly, anticoagulated patients who had fallen from standing, those under DOACs had a lower proportional incidence of bleeding complications in general and an even lower incidence of intracranial haemorrhage than in patients under VKAs. Supplementary Information The online version contains supplementary material available at 10.1186/s13049-021-00866-6.
Collapse
Affiliation(s)
- Martin Müller
- Department of Emergency Medicine, Inselspital, Bern University Hospital, Bern University, Bern, Switzerland.
| | - Ioannis Chanias
- Department of Emergency Medicine, Inselspital, Bern University Hospital, Bern University, Bern, Switzerland
| | - Michael Nagler
- University Institute of Clinical Chemistry, Inselspital Bern University Hospital, and University of Bern, Bern University, Bern, Switzerland
| | - Aristomenis K Exadaktylos
- Department of Emergency Medicine, Inselspital, Bern University Hospital, Bern University, Bern, Switzerland
| | - Thomas C Sauter
- Department of Emergency Medicine, Inselspital, Bern University Hospital, Bern University, Bern, Switzerland
| |
Collapse
|
5
|
Erdogan T, Erdogan O, Ozturk S, Oren MM, Karan MA, Bahat G. Non-vitamin K antagonist oral anticoagulant use at doses inappropriately lower than recommended in outpatient older adults: a real-life data. Eur Geriatr Med 2021; 12:809-816. [PMID: 33517553 DOI: 10.1007/s41999-021-00452-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 01/12/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND/PURPOSE There has been a rapid increase in the use of non-vitamin K-antagonist oral anticoagulants (NOAC). Current guidelines recommend dose adjustments be made in accordance with certain criteria for each NOAC. This study is aimed at determining whether or not NOAC were prescribed for non-valvular atrial fibrillation (AF) in guideline-recommended doses in community-dwelling older adults. METHODS Older adults taking NOAC for non-valvular AF presenting to a cardiology outpatient clinic for the first time were included in the study. The NOAC dose for each patient was assessed based on the recommendations of the European Society of Cardiology and were categorized as appropriate or inappropriate (low or high dose). The patients were also evaluated for demographic data, diseases, CHA2DS2-VASc score, HASBLED score, frailty and falls in the previous year. RESULTS A total of 302 older adults were included in the study, with a mean age of 75.5 ± 7.5 years. One hundred eighty-four patients (60.9%) were found to be on appropriate doses of NOAC, while 109 (36.1%) were on inappropriately low doses and nine (2.98%) were on inappropriately high doses. Accordingly, 39.1% of the AF patients were found to be on inappropriate doses of NOAC, 92.4% of which were inappropriately low. A multivariate logistic regression analysis revealed that the only factor associated with inappropriate low-dose NOAC use was patient age (OR = 1.061, 95% CI = 1.009-1.116, p = 0.022). CONCLUSION Our study suggests that the inappropriate use of lower dose NOAC may emerge as a significant problem in outpatient older adults. This inappropriate practice seems to be associated with older age rather than the diseases, CHA2DS2-VASc/HASBLED scores, frailty and presence of falls.
Collapse
Affiliation(s)
- Tugba Erdogan
- Division of Geriatrics, Department of Internal Medicine, Istanbul University, Istanbul Medical School, Istanbul, Turkey
| | - Onur Erdogan
- Department of Cardiology, Istinye State Hospital, Istanbul, Turkey
| | - Savas Ozturk
- Department of Nephrology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Meryem Merve Oren
- Department of Public Health, Istanbul University, Istanbul Medical School, Istanbul, Turkey
| | - Mehmet Akif Karan
- Division of Geriatrics, Department of Internal Medicine, Istanbul University, Istanbul Medical School, Istanbul, Turkey
| | - Gulistan Bahat
- Division of Geriatrics, Department of Internal Medicine, Istanbul University, Istanbul Medical School, Istanbul, Turkey.
| |
Collapse
|
6
|
Kwon S, Lee SR, Choi EK, Lee E, Jung JH, Han KD, Cha MJ, Oh S, Lip GYH. Non-Vitamin K Antagonist Oral Anticoagulants in Patients With Atrial Fibrillation and Prior Gastrointestinal Bleeding. Stroke 2021; 52:511-520. [PMID: 33412904 DOI: 10.1161/strokeaha.120.030761] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND PURPOSE Limited data support the benefits of non-vitamin K oral anticoagulants (NOACs) among atrial fibrillation patients with prior gastrointestinal bleeding (GIB). We aimed to evaluate the effectiveness and safety of NOACs compared with those of warfarin among atrial fibrillation patients with prior GIB. METHODS Oral anticoagulant-naive individuals with atrial fibrillation and prior GIB between January 2010 and April 2018 were identified from the Korean claims database. NOAC users were compared with warfarin users by balancing covariates using the inverse probability of treatment weighting method. The primary outcomes were ischemic stroke, major bleeding, and the composite outcome (combined ischemic stroke and major bleeding). Fatal events from each outcome were evaluated as secondary outcomes. RESULTS A total of 42 048 patients were included (24 781 in the NOAC group and 17 267 in the warfarin group). The mean time from prior GIB to the initiation of oral anticoagulant was 3.1±2.6 years. After inverse probability of treatment weighting, baseline characteristics were balanced between the two groups (mean age, 72 years; men, 56.8%; and mean CHA2DS2-VASc score, 3.7). Lower risks of ischemic stroke, major bleeding, and the composite outcome were associated with NOAC use than with warfarin use (weighted hazard ratio, 0.608 [95% CI, 0.543-0.680]; hazard ratio, 0.731 [95% CI, 0.642-0.832]; and hazard ratio, 0.661 [95% CI, 0.606-0.721], respectively). For all secondary outcomes, NOACs showed greater risk reductions compared with warfarin. CONCLUSIONS NOACs were associated with lower risks of ischemic stroke and major bleeding than warfarin among atrial fibrillation patients with prior GIB.
Collapse
Affiliation(s)
- Soonil Kwon
- Department of Internal Medicine, Seoul National University Hospital, Republic of Korea (S.K., S.-R.L., E.-K.C., M.-J.C., S.O.)
| | - So-Ryoung Lee
- Department of Internal Medicine, Seoul National University Hospital, Republic of Korea (S.K., S.-R.L., E.-K.C., M.-J.C., S.O.)
| | - Eue-Keun Choi
- Department of Internal Medicine, Seoul National University Hospital, Republic of Korea (S.K., S.-R.L., E.-K.C., M.-J.C., S.O.).,Department of Internal Medicine, Seoul National University College of Medicine, Republic of Korea (E.-K.C., S.O., G.Y.H.L.)
| | - Euijae Lee
- Department of Internal Medicine, Sejong General Hospital, Bucheon, Republic of Korea (E.L.)
| | - Jin-Hyung Jung
- Department of Medical Statistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea (J.-H.J.)
| | - Kyung-Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea (K.-D.H.)
| | - Myung-Jin Cha
- Department of Internal Medicine, Seoul National University Hospital, Republic of Korea (S.K., S.-R.L., E.-K.C., M.-J.C., S.O.)
| | - Seil Oh
- Department of Internal Medicine, Seoul National University Hospital, Republic of Korea (S.K., S.-R.L., E.-K.C., M.-J.C., S.O.).,Department of Internal Medicine, Seoul National University College of Medicine, Republic of Korea (E.-K.C., S.O., G.Y.H.L.)
| | - Gregory Y H Lip
- Department of Internal Medicine, Seoul National University College of Medicine, Republic of Korea (E.-K.C., S.O., G.Y.H.L.).,Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Chest and Heart Hospital, United Kingdom (G.Y.H.L.).,Department of Clinical Medicine, Aalborg University, Denmark (G.Y.H.L.)
| |
Collapse
|
7
|
Claxton JS, Chamberlain AM, Lutsey PL, Chen LY, MacLehose RF, Bengtson LGS, Alonso A. Association of Multimorbidity with Cardiovascular Endpoints and Treatment Effectiveness in Patients 75 Years and Older with Atrial Fibrillation. Am J Med 2020; 133:e554-e567. [PMID: 32320695 PMCID: PMC8039851 DOI: 10.1016/j.amjmed.2020.03.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 03/09/2020] [Accepted: 03/09/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The burden imposed by multimorbidity on outcomes and on the effectiveness of atrial fibrillation therapies in elderly adults with atrial fibrillation is unknown. METHODS Patients with nonvalvular atrial fibrillation ages ≥75 years in the MarketScan Medicare Supplemental database from 2007-2015. Prevalence of 14 chronic conditions at the time of atrial fibrillation diagnosis were obtained and classified as cardiometabolic or noncardiometabolic. Cox regression estimated the associations of the number and type of conditions with stroke, severe bleeding, and heart failure hospitalizations. Tests for interaction were assessed between atrial fibrillation treatments and multimorbidity. RESULTS Among 275,617 patients with atrial fibrillation (mean age 83 years, 51% women), the mean (SD) number of conditions per participant was 3.0 (2.1). Over a mean follow-up of 23 months, 7814 strokes, 13,622 severe bleeds, and 19,252 heart failure events occurred. After adjustment, an increase in the number of cardiometabolic conditions was associated with greater risk of stroke (hazard ratio [HR] 1.07; 95% confidence interval [CI], 1.05-1.10), severe bleeding (HR 1.09; 95% CI, 1.07-1.11), and heart failure (HR 1.19, 95% CI, 1.18-1.20). In contrast, number of noncardiometabolic conditions had weak or null associations with risk of cardiovascular endpoints. Overall, the effectiveness of atrial fibrillation treatment on stroke and heart failure were similar across multimorbidity status, but bleeding risk associated with atrial fibrillation treatments was higher in patients with overall and subgroup multimorbidity. CONCLUSION Cardiometabolic multimorbidity was associated with worse outcomes and modified bleeding risk in atrial fibrillation patients. These findings underscore the impact of cardiometabolic conditions on atrial fibrillation outcomes and highlights the need to incorporate multimorbidity management in atrial fibrillation treatment guidelines.
Collapse
Affiliation(s)
- J'Neka S Claxton
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Ga. j'
| | | | - Pamela L Lutsey
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis
| | - Lin Y Chen
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis
| | - Richard F MacLehose
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis
| | - Lindsay G S Bengtson
- Health Economics and Outcomes Research, Life Sciences, Optum, Eden Prairie, Minn
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Ga
| |
Collapse
|
8
|
de Groot JR, Weiss TW, Kelly P, Monteiro P, Deharo JC, de Asmundis C, López-de-Sá E, Waltenberger J, Steffel J, Levy P, Bakhai A, Zierhut W, Laeis P, Manu MC, Reimitz PE, De Caterina R, Kirchhof P. Edoxaban for stroke prevention in atrial fibrillation in routine clinical care: 1-year follow-up of the prospective observational ETNA-AF-Europe study. EUROPEAN HEART JOURNAL. CARDIOVASCULAR PHARMACOTHERAPY 2020; 7:f30-f39. [PMID: 32790837 PMCID: PMC8117428 DOI: 10.1093/ehjcvp/pvaa079] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/28/2020] [Accepted: 08/05/2020] [Indexed: 01/16/2023]
Abstract
Aims Non-vitamin K oral anticoagulants are safe and effective for stroke prevention in patients with atrial fibrillation (AF). Data on the safety and efficacy of edoxaban in routine care are limited in Europe. We report 1-year outcomes in patients with AF treated with edoxaban in routine care. Methods and results ETNA-AF-Europe is a prospective, multicentre, post-authorization, observational study enrolling patients treated with edoxaban in 10 European countries, the design of which was agreed with the European Medicines Agency as part of edoxaban’s post-approval safety plan. Altogether 13 092 patients in 852 sites completed the 1-year follow-up [mean age: 73.6 ± 9.5 years; 57% male, mean follow-up: 352 ± 49 days (median: 366 days)]. Most patients had associated comorbidities (mean CHA2DS2-VASc score: 3.1 ± 1.4). Stroke or systemic embolism was reported in 103 patients (annualized event rate: 0.82%/year), and major bleeding events were reported in 132 patients (1.05%/year). Rates of intracranial haemorrhage were low [30 patients (0.24%/year)]. Death occurred in 442 patients (3.50%/year); cardiovascular (CV) death occurred in 206 patients (1.63%/year). The approved dosing of edoxaban was chosen in 83%. All-cause and CV mortality were higher in patients receiving edoxaban 30 mg vs. 60 mg, in line with the higher age and more frequent comorbidities of the 30 mg group. Major bleeding was also numerically more common in patients receiving edoxaban 30 mg vs. 60 mg. Conclusion The rates of stroke, systemic embolism, and major bleeding are low in this large unselected cohort of high-risk AF patients routinely treated with edoxaban.
Collapse
Affiliation(s)
- Joris R de Groot
- Department of Cardiology, Amsterdam University Medical Centres/University of Amsterdam, Spui 21 1012 WX Amsterdam, The Netherlands
| | - Thomas W Weiss
- Institute for Cardiometabolic Diseases, Karl Landsteiner Society, St. Pölten, Austria
| | - Peter Kelly
- Department of Neurology, HRB Stroke Clinical Trials Network Ireland, University College Dublin/Mater Misericordiae University Hospital, Eccles St, Northside, Dublin, Ireland
| | - Pedro Monteiro
- Department of Cardiology, Centro Hospitalar e Universitário de Coimbra, Praceta Mota Pinto 3000-075, Coimbra, Portugal
| | - Jean Claude Deharo
- AP-HM, Aix Marseille University, Hôpital Timone, Cardiologie, Rythmologie, 264 rue Saint-Pierre, 13005, Marseille, France
| | - Carlo de Asmundis
- Department of Cardiology, Universitair Ziekenhuis Brussels, Ninoofsesteenweg 134, 1700 Dilbeek, Belgium
| | - Esteban López-de-Sá
- Cardiological Intensive Care Unit, Cardiology Service, Hospital Universitario La Paz, IDIPAZ, CIBER-CV, Madrid, Spain
| | - Johannes Waltenberger
- Department of Cardiovascular Medicine, University of Munster, Schlossplatz 2, 48149 Münster, Germany.,Department of Internal Medicine I, SRH Central Hospital Suhl, Albert-Schweitzer-Straße 2, 98527 Suhl, Germany
| | - Jan Steffel
- Department of Cardiology, University Hospital of Zurich, Rämistrasse 100, 8091 Zurich, Switzerland
| | - Pierre Levy
- Department of Economics, Université Paris-Dauphine, PSL Research University, LEDa-LEGOS, Paris, France
| | - Ameet Bakhai
- Department of Cardiology, Royal Free London NHS Foundation Trust, Pond Street, London NW3 2QG, UK
| | - Wolfgang Zierhut
- Daiichi Sankyo Europe GmbH, Zielstattstr. 48, 81379 Munich, Germany
| | - Petra Laeis
- Daiichi Sankyo Europe GmbH, Zielstattstr. 48, 81379 Munich, Germany
| | | | | | - Raffaele De Caterina
- Chair of Cardiology, University of Pisa, Lungarno Antonio Pacinotti, 43, 56126 Pisa, Italy
| | - Paulus Kirchhof
- Institute of Cardiovascular Sciences, University of Birmingham, SWBH and UHB NHS Trusts, IBR 136, Wolfson Drive, Birmingham B15 2TT, UK.,Department of Cardiology, University Heart and Vascular Centre Hamburg, Villa Garbrecht, Martinistraße 52, 20251 Hamburg, Germany.,The Atrial Fibrillation NETwork (AFNET), Münster, Germany
| |
Collapse
|
9
|
Wang CL, Wu VCC, Chang KH, Chang SH. Response to the 'Breaking the rules for studies using real-world observational data: the case of direct-acting anticoagulants and antiepileptic drugs by Dr Brown et al.'. EUROPEAN HEART JOURNAL. CARDIOVASCULAR PHARMACOTHERAPY 2020; 6:157-158. [PMID: 31593220 DOI: 10.1093/ehjcvp/pvz054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Chun-Li Wang
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou Medical Center, No. 5, Fu-Shin St. Kwei-Shan District, 33305 Taoyuan, Taiwan
- College of Medicine, Chang Gung University, No. 259, Wen-Hua 1st Road, Kwei-Shan District, 33302 Taoyuan, Taiwan
| | - Victor Chien-Chia Wu
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou Medical Center, No. 5, Fu-Shin St. Kwei-Shan District, 33305 Taoyuan, Taiwan
| | - Kuo-Hsuan Chang
- College of Medicine, Chang Gung University, No. 259, Wen-Hua 1st Road, Kwei-Shan District, 33302 Taoyuan, Taiwan
- Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Shang-Hung Chang
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou Medical Center, No. 5, Fu-Shin St. Kwei-Shan District, 33305 Taoyuan, Taiwan
- College of Medicine, Chang Gung University, No. 259, Wen-Hua 1st Road, Kwei-Shan District, 33302 Taoyuan, Taiwan
- Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Linkou Medical Center, No. 5, Fu-Shin St. Kwei-Shan District, 33305 Taoyuan, Taiwan
- Graduate Institute of Nursing, Chang Gung University of Science and Technology, No. 261, Wen-Hua 1st Road, Kwei-Shan District, 33302 Taoyuan, Taiwan
| |
Collapse
|
10
|
Başaran Ö, Biteker M. Switching among oral anticoagulants: is it logical? Curr Med Res Opin 2020; 36:177-178. [PMID: 31462076 DOI: 10.1080/03007995.2019.1662196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Özcan Başaran
- Department of Cardiology, Mugla Sitki Kocman University, Education and Research Hospital, Muğla, Turkey
| | - Murat Biteker
- Department of Cardiology, Faculty of Medicine, Mugla Sitki Kocman University, Muğla, Turkey
| |
Collapse
|
11
|
Choi JI. Benefit, Risk and Cost in Oral Anticoagulation for Stroke Prevention: Is It the Third Factor? Korean Circ J 2019; 49:264-266. [PMID: 30808075 PMCID: PMC6393324 DOI: 10.4070/kcj.2019.0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 01/20/2019] [Indexed: 11/29/2022] Open
Affiliation(s)
- Jong-Il Choi
- Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine and Korea University Medical Center, Seoul, Korea
| |
Collapse
|