Loading...
Please wait, while we are loading the content...
Similar Documents
Efficacy and Safety of Non–Vitamin K Antagonist Oral Anticoagulants in Atrial Fibrillation Patients With Impaired Liver Function: A Retrospective Cohort Study
| Content Provider | Semantic Scholar |
|---|---|
| Author | Wang, Chun‐ Li Wu, Victor Kuo, Chang‐ Fu Chu, Pao‐ Hsien Tseng, Hsiao‐ Jung Wen, Ming‐ Shien Chang, Shang‐ Hung |
| Copyright Year | 2018 |
| Abstract | Background Patients with impaired liver function ( ILF ) were excluded from clinical trials that investigated non-vitamin K antagonist oral anticoagulants ( NOAC s) for stroke prevention in patients with atrial fibrillation. The aim of this study was to evaluate the efficacy and safety of NOAC s in atrial fibrillation patients with ILF . Methods and Results A cohort study based on electronic medical records was conducted from 2009 to 2016 at a multicenter healthcare provider in Taiwan and included 6451 anticoagulated atrial fibrillation patients (aged 76.7±7.0 years, 52.5% male). Patients were classified into 2 subgroups: patients with normal liver function (n=5818) and patients with ILF (n=633, 9.8%). Cox regression analysis was performed to investigate the risks of thromboembolism, bleeding, and death associated with use of NOAC s and warfarin in patients with normal liver function and ILF , respectively. In patients with normal liver function, compared with warfarin therapy (n=2928), NOAC therapy (n=4048) was associated with significantly lower risks of stroke or systemic embolism (adjusted hazard ratio: 0.75; 95% confidence interval, 0.65-0.88; P<0.001) and death (adjusted hazard ratio: 0.69; 95% confidence interval, 0.60-0.80; P<0.001) with no difference in major bleeding or gastrointestinal bleeding. In patients with ILF , compared with warfarin therapy (n=394), NOAC therapy (n=342) was associated with significantly lower risk of death (adjusted hazard ratio: 0.64; 95% confidence interval, 0.49-0.83; P<0.001), but no difference in stroke or systemic embolism, major bleeding, or gastrointestinal bleeding. Conclusions In atrial fibrillation patients with ILF , NOAC therapy and warfarin therapy were associated with similar risks of stroke or systemic embolism, major bleeding, and gastrointestinal bleeding. |
| Starting Page | 2162 |
| Ending Page | 2175 |
| Page Count | 14 |
| File Format | PDF HTM / HTML |
| PubMed reference number | 30371232v1 |
| Alternate Webpage(s) | https://doi.org/10.1161/JAHA.118.009263 |
| DOI | 10.1161/jaha.118.009263 |
| Journal | Journal of the American Heart Association |
| Volume Number | 7 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Atrial Fibrillation Cerebrovascular accident Cessation of life Classification Confidence Intervals Cooley's anemia Electronic Health Records Embolism Exclusion Gastrointestinal Hemorrhage Hazard Ratio Heart Atrium Liver Dysfunction Liver diseases N(4)-oleylcytosine arabinoside Patients Status Epilepticus Thromboembolism Vitamin K Warfarin oral anticoagulants |
| Content Type | Text |
| Resource Type | Article |
