Cited 39 times in
The Optimal Drug Adherence to Maximize the Efficacy and Safety of Non-Vitamin K Antagonist Oral Anticoagulant in Real-World Atrial Fibrillation Patients
DC Field | Value | Language |
---|---|---|
dc.contributor.author | 김종윤 | - |
dc.contributor.author | 김태훈 | - |
dc.contributor.author | 박희남 | - |
dc.contributor.author | 엄재선 | - |
dc.contributor.author | 유희태 | - |
dc.contributor.author | 이문형 | - |
dc.contributor.author | 장은선 | - |
dc.contributor.author | 정보영 | - |
dc.contributor.author | 김대훈 | - |
dc.date.accessioned | 2020-06-17T00:45:39Z | - |
dc.date.available | 2020-06-17T00:45:39Z | - |
dc.date.issued | 2020-04 | - |
dc.identifier.issn | 1099-5129 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/176110 | - |
dc.description.abstract | Aims: To investigate the association between adherence to non-vitamin K antagonist oral anticoagulant (NOAC) and clinical outcomes and to determine the optimal cut-off level of NOAC adherence among patients with atrial fibrillation (AF). Methods and results: Using the Korean National Health Insurance Service database, we identified 96 197 patients with non-valvular AF who initiated NOAC or warfarin in 2013-16. We compared clinical outcomes between adherent [proportion of days covered (PDC) ≥80%] vs. non-adherent (PDC <80%) NOAC users, and further with warfarin users. We assessed the outcomes according to different levels of adherence. The proportion of adherent NOAC users was 64.0%. Compared with non-adherent NOAC users, adherent NOAC users were at lower risks of ischaemic stroke/systemic embolism (SE) [adjusted hazard ratio (aHR) 0.73, 95% confidence interval (CI) 0.69-0.79], and myocardial infarction (aHR 0.82, 95% CI 0.72-0.93), whereas there was no significant risk alteration for major bleeding (aHR 1.01, 95% CI 0.91-1.11). Compared with warfarin, non-adherent NOAC use failed to have better efficacy against ischaemic stroke/SE (aHR 0.99, 95% CI 0.93-1.05) and rather had increased risk of myocardial infarction (aHR 1.13, 95% CI 1.03-1.25). In NOAC users, the risks of adverse outcomes decreased according to gradual increase of adherence rates with the lowest risks in ≥90%, except for major bleeding in which there were no significant associations. Conclusions: In an adherence level-dependent fashion, adherent use of NOAC showed better clinical outcomes without increasing bleeding risk. Maintaining ≥90% of adherence optimizes effectiveness of NOAC therapy without compromising its safety. | - |
dc.description.statementOfResponsibility | restriction | - |
dc.language | English | - |
dc.publisher | Oxford University Press | - |
dc.relation.isPartOf | EUROPACE | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.title | The Optimal Drug Adherence to Maximize the Efficacy and Safety of Non-Vitamin K Antagonist Oral Anticoagulant in Real-World Atrial Fibrillation Patients | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Internal Medicine (내과학교실) | - |
dc.contributor.googleauthor | Daehoon Kim | - |
dc.contributor.googleauthor | Pil-Sung Yang | - |
dc.contributor.googleauthor | Eunsun Jang | - |
dc.contributor.googleauthor | Hee Tae Yu | - |
dc.contributor.googleauthor | Tae-Hoon Kim | - |
dc.contributor.googleauthor | Jae-Sun Uhm | - |
dc.contributor.googleauthor | Jong-Youn Kim | - |
dc.contributor.googleauthor | Jung-Hoon Sung | - |
dc.contributor.googleauthor | Hui-Nam Pak | - |
dc.contributor.googleauthor | Moon-Hyoung Lee | - |
dc.contributor.googleauthor | Gregory Y H Lip | - |
dc.contributor.googleauthor | Boyoung Joung | - |
dc.identifier.doi | 10.1093/europace/euz273 | - |
dc.contributor.localId | A00926 | - |
dc.contributor.localId | A01085 | - |
dc.contributor.localId | A01776 | - |
dc.contributor.localId | A02337 | - |
dc.contributor.localId | A02535 | - |
dc.contributor.localId | A02766 | - |
dc.contributor.localId | A05608 | - |
dc.contributor.localId | A03609 | - |
dc.relation.journalcode | J00801 | - |
dc.identifier.eissn | 1532-2092 | - |
dc.identifier.pmid | 31598651 | - |
dc.identifier.url | https://academic.oup.com/europace/article-lookup/doi/10.1093/europace/euz273 | - |
dc.subject.keyword | Anticoagulation | - |
dc.subject.keyword | Atrial fibrillation | - |
dc.subject.keyword | Drug adherence | - |
dc.subject.keyword | Non-vitamin K antagonist oral anticoagulant | - |
dc.subject.keyword | Stroke | - |
dc.subject.keyword | Treatment outcome | - |
dc.contributor.alternativeName | Kim, Jong Youn | - |
dc.contributor.affiliatedAuthor | 김종윤 | - |
dc.contributor.affiliatedAuthor | 김태훈 | - |
dc.contributor.affiliatedAuthor | 박희남 | - |
dc.contributor.affiliatedAuthor | 엄재선 | - |
dc.contributor.affiliatedAuthor | 유희태 | - |
dc.contributor.affiliatedAuthor | 이문형 | - |
dc.contributor.affiliatedAuthor | 장은선 | - |
dc.contributor.affiliatedAuthor | 정보영 | - |
dc.citation.volume | 22 | - |
dc.citation.number | 4 | - |
dc.citation.startPage | 547 | - |
dc.citation.endPage | 557 | - |
dc.identifier.bibliographicCitation | EUROPACE, Vol.22(4) : 547-557, 2020-04 | - |
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.