N. B, S. M., Mahfuzah I, Nur Amal Liyana O, Nurul Aiman Z, N. Am
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Data were collected from Warfarin registration book, drug usage record card and Hospital Information System. 142 patients (Warfarin, n=98; Dabigatran, n=30; Rivaroxaban, n=14) with mean age of 68±8.7 years old were included in the study. Majority of them were male, Malay and non-smoker with 57.0%, 97.2% and 95.8% respectively. Upon study enrolment, all patients were at moderate risk of stroke (median CHA2DS2-VASc score=3) and low risk of bleeding (median HAS-BLED score=2). One Ischemic stroke was identified in each group of Rivaroxaban 15 mg and Dabigatran 150 mg. Four bleeding events occurred in all groups except for Dabigatran group that were hematuria, gum bleeding and upper gastrointestinal bleeding. Thromboembolism and bleeding events still occur in all groups. However, the prevalence is small in our setting with the percentage of 1.4% and 2.8% respectively. 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Therefore, we investigated the prevalence of thromboembolism (stroke or systemic embolism) and bleeding events in patients receiving Warfarin, Dabigatran or Rivaroxaban in our setting. This retrospective cohort study involved patients with nonvalvular atrial fibrillation who were started on Warfarin, Dabigatran or Rivaroxaban from January 1, 2014 to December 31, 2018. To fulfil inclusion criteria, patients must be on treatment for at least one year and for Warfarin group, at least 65% of Time in Therapeutic Range (TTR) should be achieved. Data were collected from Warfarin registration book, drug usage record card and Hospital Information System. 142 patients (Warfarin, n=98; Dabigatran, n=30; Rivaroxaban, n=14) with mean age of 68±8.7 years old were included in the study. Majority of them were male, Malay and non-smoker with 57.0%, 97.2% and 95.8% respectively. 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引用次数: 0
摘要
Sultanah Nur Zahirah医院(HSNZ)每年使用达比加群和利伐沙班的趋势增加,与华法林相比,引起了对其有效性和安全性的担忧。因此,我们调查了接受华法林、达比加群或利伐沙班治疗的患者血栓栓塞(中风或全身栓塞)和出血事件的发生率。这项回顾性队列研究纳入了2014年1月1日至2018年12月31日期间开始服用华法林、达比加群或利伐沙班的非瓣膜性心房颤动患者。为了满足纳入标准,患者必须接受至少一年的治疗,华法林组至少应达到65%的治疗范围时间(TTR)。数据来源于华法林登记簿、用药记录卡和医院信息系统。142例患者(华法林,n=98;Dabigatran n = 30;纳入利伐沙班患者14例,平均年龄68±8.7岁。以男性、马来人及不吸烟为主,分别占57.0%、97.2%及95.8%。研究入组时,所有患者卒中风险为中等(CHA2DS2-VASc评分中位数为3),出血风险为低(HAS-BLED评分中位数为2)。利伐沙班15mg和达比加群150mg组各有1例缺血性卒中。除达比加群组血尿、牙龈出血和上消化道出血外,其他组均发生4例出血事件。所有组仍发生血栓栓塞和出血事件。然而,在我们的环境中,患病率很小,分别为1.4%和2.8%。这些事件大多归因于易感的危险因素。
The Thromboembolism and Bleeding Event in Patients Receiving Warfarin, Dabigatran, or Rivaroxaban in Nonvalvular Atrial Fibrillation
Increasing in trend of Dabigatran and Rivaroxaban usage every year in Hospital Sultanah Nur Zahirah (HSNZ) has raised concerns regarding their effectiveness and safety compared to Warfarin. Therefore, we investigated the prevalence of thromboembolism (stroke or systemic embolism) and bleeding events in patients receiving Warfarin, Dabigatran or Rivaroxaban in our setting. This retrospective cohort study involved patients with nonvalvular atrial fibrillation who were started on Warfarin, Dabigatran or Rivaroxaban from January 1, 2014 to December 31, 2018. To fulfil inclusion criteria, patients must be on treatment for at least one year and for Warfarin group, at least 65% of Time in Therapeutic Range (TTR) should be achieved. Data were collected from Warfarin registration book, drug usage record card and Hospital Information System. 142 patients (Warfarin, n=98; Dabigatran, n=30; Rivaroxaban, n=14) with mean age of 68±8.7 years old were included in the study. Majority of them were male, Malay and non-smoker with 57.0%, 97.2% and 95.8% respectively. Upon study enrolment, all patients were at moderate risk of stroke (median CHA2DS2-VASc score=3) and low risk of bleeding (median HAS-BLED score=2). One Ischemic stroke was identified in each group of Rivaroxaban 15 mg and Dabigatran 150 mg. Four bleeding events occurred in all groups except for Dabigatran group that were hematuria, gum bleeding and upper gastrointestinal bleeding. Thromboembolism and bleeding events still occur in all groups. However, the prevalence is small in our setting with the percentage of 1.4% and 2.8% respectively. The events mostly attributed by the predisposed risk factors.