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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한응급의학회 Clinical and Experimental Emergency Medicine Clinical and Experimental Emergency Medicine Vol.5 No.1
- 발행연도
- 2018.1
- 수록면
- 43 - 50 (8page)
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초록· 키워드
오류제보하기
Objective Patients with nonvalvular atrial fibrillation (AF) and renal disease (RD) who receive anticoagulation therapy appear to be at greater risk of major bleeding (MB) than AF patients without RD. As observed in past studies, anticoagulants are frequently withheld from AF patients with RD due to concerns regarding bleeding. The objective of this study was to evaluate the incidence and pattern of MB in those with RD, as compared to those without RD, in a population of rivaroxaban users with nonvalvular AF. Methods Electronic medical records of over 10 million patients from the Department of Defense Military Health System were queried to identify rivaroxaban users with nonvalvular AF. A validated algorithm was used to identify MB-related hospitalizations. RD was defined through diagnostic codes present within 6 months prior to the bleeding date for MB cases and end of study participation for non-MB patients. Data were collected on patient characteristics, comorbidities, MB management, and outcomes. Results Overall, 44,793 rivaroxaban users with nonvalvular AF were identified. RD was present among 6,921 patients (15.5%). Patients with RD had a higher rate of MB than those without RD, 4.52 per 100 person-years versus 2.54 per 100 person-years, respectively. The fatal bleeding outcome rate (0.09 per 100 person-years) was identical between those with and without RD. Conclusion In this post-marketing study of 44,793 rivaroxaban users with nonvalvular AF, RD patients experienced a higher MB rate than those without RD. The higher rate of MB among those with RD may be due to the confounding effects of comorbidities.
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참고문헌 (30)
참고문헌 신청
Mookadam M / 2015 / Novel anticoagulants in atrial fibrillation: a primer for the primary physician / J Am Board Fam Med 28:510~522
Camm AJ / 2010 / Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC) / Europace 12:1360~1420
Fox KA / 2011 / Prevention of stroke and systemic embolism with rivaroxaban compared with warfarin in patients with non-valvular atrial fibrillation and moderate renal impairment / Eur Heart J 32:2387~2394
Fang MC / 2011 / A new risk scheme to predict warfarin-associated hemorrhage: the ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation) Study / J Am Coll Cardiol 58:395~401
Marinigh R / 2010 / Age as a risk factor for stroke in atrial fibrillation patients: implications for thromboprophylaxis / J Am Coll Cardiol 56:827~837
Camm AJ / 2010 / Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC) / Europace 12:1360~1420
Fox KA / 2011 / Prevention of stroke and systemic embolism with rivaroxaban compared with warfarin in patients with non-valvular atrial fibrillation and moderate renal impairment / Eur Heart J 32:2387~2394
Fang MC / 2011 / A new risk scheme to predict warfarin-associated hemorrhage: the ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation) Study / J Am Coll Cardiol 58:395~401
Marinigh R / 2010 / Age as a risk factor for stroke in atrial fibrillation patients: implications for thromboprophylaxis / J Am Coll Cardiol 56:827~837
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