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Anticoagulation therapy in atrial fibrillation after intracranial hemorrhage

DC FieldValueLanguage
dc.contributor.author박영아-
dc.contributor.author박희남-
dc.contributor.author엄재선-
dc.contributor.author이문형-
dc.contributor.author정보영-
dc.date.accessioned2017-10-26T07:24:17Z-
dc.date.available2017-10-26T07:24:17Z-
dc.date.issued2016-
dc.identifier.issn1547-5271-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/151986-
dc.description.abstractBACKGROUND: The effect of oral anticoagulation therapy (OAT) in patients with atrial fibrillation (AF) with a history of intracranial hemorrhage (ICH) is poorly defined. OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of OAT in patients with AF with an ICH history. METHODS: We retrospectively compared the composite end point, including thromboembolic and major bleeding events, between patients with AF with a history of ICH who were (OAT group, n = 254) and those who were not (no-OAT group, n = 174) taking OAT. RESULTS: During a mean follow-up of 39.5 ± 31.9 months, 5.5 and 3.1 major bleeding events/100 patient-years were observed in the OAT and no-OAT groups, respectively (P = .024). Recurrent ICH was observed only in patient with OAT. Thromboembolic events occurred in 2.4 and 8.3 events/100 patient-years in OAT and no-OAT groups, respectively (P < .001). There was no significant differences in composite end points between OAT and no-OAT groups (11.5 events/100 patient-years vs 7.9 events/100 patient-years; P = .154). Patients with OAT who achieved a time-in-therapeutic range of ≥60% of the international normalized ratio of 2.0-3.0 demonstrated a better cumulative survival free of the composite end point (P < .001) than did patients without OAT. Early (<2 weeks) OAT after an index ICH did not improve composite end points because of the increased incidence of major bleeding events. However, OAT at 2 weeks after an index ICH was associated with decreased clinical events including thromboembolic events and composite end point. CONCLUSION: In patients with AF who require anticoagulation and have a history of ICH, maintaining optimal OAT with time-in-therapeutic range ≥ 60% and the initiation of OAT at least 2 weeks after an index ICH were associated with improved clinical outcomes.-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherElsevier-
dc.relation.isPartOfHEART RHYTHM-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAdministration, Oral-
dc.subject.MESHAged-
dc.subject.MESHAnticoagulants/administration & dosage*-
dc.subject.MESHAnticoagulants/adverse effects-
dc.subject.MESHAtrial Fibrillation/complications*-
dc.subject.MESHFemale-
dc.subject.MESHHumans-
dc.subject.MESHIntracranial Hemorrhages/chemically induced*-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHRisk Assessment-
dc.subject.MESHStroke/etiology-
dc.subject.MESHStroke/prevention & control*-
dc.subject.MESHWarfarin/administration & dosage*-
dc.subject.MESHWarfarin/adverse effects-
dc.titleAnticoagulation therapy in atrial fibrillation after intracranial hemorrhage-
dc.typeArticle-
dc.publisher.locationUnited States-
dc.contributor.collegeCollege of Medicine-
dc.contributor.departmentDept. of Internal Medicine-
dc.contributor.googleauthorYoung-Ah Park-
dc.contributor.googleauthorJae-Sun Uhm-
dc.contributor.googleauthorHui-Nam Pak-
dc.contributor.googleauthorMoon-Hyoung Lee-
dc.contributor.googleauthorBoyoung Joung-
dc.identifier.doi10.1016/j.hrthm.2016.05.016-
dc.contributor.localIdA01776-
dc.contributor.localIdA02337-
dc.contributor.localIdA02766-
dc.contributor.localIdA03609-
dc.contributor.localIdA04936-
dc.relation.journalcodeJ00980-
dc.identifier.eissn1556-3871-
dc.identifier.pmid27554947-
dc.identifier.urlhttp://www.sciencedirect.com/science/article/pii/S1547527116303174-
dc.subject.keywordAnticoagulation-
dc.subject.keywordAtrial fibrillation-
dc.subject.keywordBleeding-
dc.subject.keywordIntracranial hemorrhage-
dc.subject.keywordThromboembolic events-
dc.contributor.alternativeNamePark, Young Ah-
dc.contributor.alternativeNamePak, Hui Nam-
dc.contributor.alternativeNameUhm, Jae Sun-
dc.contributor.alternativeNameLee, Moon Hyoung-
dc.contributor.alternativeNameJoung, Bo Young-
dc.contributor.affiliatedAuthorPak, Hui Nam-
dc.contributor.affiliatedAuthorUhm, Jae Sun-
dc.contributor.affiliatedAuthorLee, Moon Hyoung-
dc.contributor.affiliatedAuthorJoung, Bo Young-
dc.contributor.affiliatedAuthorPark, Young Ah-
dc.citation.volume13-
dc.citation.number9-
dc.citation.startPage1794-
dc.citation.endPage1802-
dc.identifier.bibliographicCitationHEART RHYTHM, Vol.13(9) : 1794-1802, 2016-
dc.date.modified2017-10-24-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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