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Bleeding risk and major adverse events in patients with previous ulcer on oral anticoagulation therapy

DC FieldValueLanguage
dc.contributor.author박희남-
dc.contributor.author신동호-
dc.contributor.author이문형-
dc.contributor.author이승준-
dc.contributor.author정보영-
dc.contributor.author황혜진-
dc.contributor.author김종윤-
dc.date.accessioned2014-12-19T16:22:36Z-
dc.date.available2014-12-19T16:22:36Z-
dc.date.issued2012-
dc.identifier.issn0002-9149-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/89410-
dc.description.abstractBleeding is the major concern for patients receiving oral anticoagulation therapy (OAT), especially those with histories of gastrointestinal ulcer. The aim of this study was to evaluate the efficacy and safety of OAT in patients with nonvalvular atrial fibrillation with histories of ulcer. A composite end point, including major adverse cardiac events or major bleeding, was compared between patients with AF with previous ulcers who were (OAT+; n = 200) and were not (OAT- n = 230) receiving OAT. During the follow-up period of 3.3 ± 2.7 years, 28 (14%) and 66 (29%) OAT+ and OAT- patients, respectively, had major adverse cardiac events (p = 0.001). Major bleeding occurred in 46 OAT+ patients (23%) and 25 OAT- patients (11%) (p = 0.001). There was no significant difference in the composite end point between OAT+ and OAT- patients (29% vs 36%, p = 0.08). The incidence of major bleeding was significantly lower, decreasing from 30% to 14%, when OAT began after endoscopic confirmation of ulcer healing (p = 0.02). OAT+ patients who achieved time in the therapeutic range ≥60% for international normalized ratio (2.0 to 3.0) demonstrated better cumulative survival free from the composite end point than OAT- patients (p = 0.01). In conclusion, OAT in patients with nonvalvular AF with histories of gastrointestinal ulcer made no difference in the composite end point compared to absence of OAT. In OAT+ patients, maintaining an optimal international normalized ratio reduced the composite end point, and the confirmation of ulcer healing reduced the incidence of bleeding.-
dc.description.statementOfResponsibilityopen-
dc.relation.isPartOfAMERICAN JOURNAL OF CARDIOLOGY-
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.MESHAtrial Fibrillation/drug therapy*-
dc.subject.MESHFemale-
dc.subject.MESHHemorrhage/chemically induced*-
dc.subject.MESHHemorrhage/epidemiology*-
dc.subject.MESHHumans-
dc.subject.MESHMale-
dc.subject.MESHPeptic Ulcer/complications*-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHRisk Factors-
dc.titleBleeding risk and major adverse events in patients with previous ulcer on oral anticoagulation therapy-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학)-
dc.contributor.googleauthorSeung-Jun Lee-
dc.contributor.googleauthorDong-Ho Shin-
dc.contributor.googleauthorHye-Jin Hwang-
dc.contributor.googleauthorJong-Youn Kim-
dc.contributor.googleauthorHui-Nam Pak-
dc.contributor.googleauthorMoon-Hyoung Lee-
dc.contributor.googleauthorBoyoung Joung-
dc.identifier.doi22516526-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA01776-
dc.contributor.localIdA02097-
dc.contributor.localIdA02766-
dc.contributor.localIdA02927-
dc.contributor.localIdA03609-
dc.contributor.localIdA04496-
dc.contributor.localIdA00926-
dc.relation.journalcodeJ00071-
dc.identifier.eissn1879-1913 -
dc.identifier.pmid22516526-
dc.identifier.urlhttp://www.sciencedirect.com/science/article/pii/S0002914912010521-
dc.subject.keywordAdministration, Oral-
dc.subject.keywordAged-
dc.subject.keywordAnticoagulants/administration & dosage-
dc.subject.keywordAnticoagulants/adverse effects*-
dc.subject.keywordAtrial Fibrillation/complications*-
dc.subject.keywordAtrial Fibrillation/drug therapy*-
dc.subject.keywordFemale-
dc.subject.keywordHemorrhage/chemically induced*-
dc.subject.keywordHemorrhage/epidemiology*-
dc.subject.keywordHumans-
dc.subject.keywordMale-
dc.subject.keywordPeptic Ulcer/complications*-
dc.subject.keywordRetrospective Studies-
dc.subject.keywordRisk Factors-
dc.contributor.alternativeNamePak, Hui Nam-
dc.contributor.alternativeNameShin, Dong Ho-
dc.contributor.alternativeNameLee, Moon Hyoung-
dc.contributor.alternativeNameLee, Seung Jun-
dc.contributor.alternativeNameJoung, Bo Young-
dc.contributor.alternativeNameHwang, Hye Jin-
dc.contributor.alternativeNameKim, Jong Youn-
dc.contributor.affiliatedAuthorPak, Hui Nam-
dc.contributor.affiliatedAuthorShin, Dong Ho-
dc.contributor.affiliatedAuthorLee, Moon Hyoung-
dc.contributor.affiliatedAuthorLee, Seung Jun-
dc.contributor.affiliatedAuthorJoung, Bo Young-
dc.contributor.affiliatedAuthorHwang, Hye Jin-
dc.contributor.affiliatedAuthorKim, Jong Youn-
dc.citation.volume110-
dc.citation.number3-
dc.citation.startPage373-
dc.citation.endPage377-
dc.identifier.bibliographicCitationAMERICAN JOURNAL OF CARDIOLOGY, Vol.110(3) : 373-377, 2012-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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