http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
- 中文 을 입력하시려면 zhongwen을 입력하시고 space를누르시면됩니다.
- 北京 을 입력하시려면 beijing을 입력하시고 space를 누르시면 됩니다.
RISS 인기검색어
- 검색키워드
- 저자 : Gregory YH Lip (검색결과 2 건)
- 무료
- 기관 내 무료
- 유료
-
Stroke and Bleeding Risk in Atrial Fibrillation
Keitaro Senoo,Deirdre Lane,Gregory YH Lip 대한심장학회 2014 Korean Circulation Journal Vol.44 No.5
Non-valvular atrial fibrillation (AF) is the most common cardiac arrhythmia in the clinical setting. AF increases both the risk and severityof strokes, and is associated with substantial morbidity and mortality. Despite the clear net clinical benefit of oral anticoagulants (OACs)in patients with AF at risk for stroke, major bleeding events, especially intracranial bleeds, may be devastating. In the last decade, four newOACs have been approved for stroke prevention in patients with AF and are at least as effective as warfarin with better bleeding profiles. These new agents have changed and simplified our approach to stroke prevention because the threshold for initiation of OACs is lowered. An important clinical practice shift is the initial identification of “low-risk” patients who do not need antithrombotic therapy, with low-riskcomprising CHA2DS2-VASc {Congestive heart failure, Hypertension, Age ≥75 years (double), Diabetes mellitus, previous Stroke/transientischemic attack/thromboembolism (double), Vascular disease, Age 65–74 years, and female gender (score of 0 for males and 1 for female)}. Subsequent to this step, effective stroke prevention consisting of OACs can be offered to patients with one or more stroke risk factors. Apart from stroke risk, another consideration is bleeding risk assessment, with a focus on the use of the validated HAS-BLED {Hypertension,Abnormal renal/liver function, Stroke, Bleeding history, Labile international normalized ratio (INR), Elderly (age >65 years), drugs or alcoholconcomitantly} score. A high HAS-BLED score can flag patients potentially at risk for bleeding, and alert clinicians to the need for carefulreview and follow up, and the need to consider potentially correctable bleeding risk factors that include uncontrolled hypertension,labile INRs, concomitant aspirin use, and alcohol excess.
-
So-Ryoung Lee,Ji Hyun Lee,Eue-Keun Choi,Eun-Kyung Jung,So-Jeong You,Seil Oh,Gregory YH Lip 대한심장학회 2024 Korean Circulation Journal Vol.54 No.1
Background and Objectives: Comprehensive epidemiological data are lacking on the incident atrial fibrillation (AF) in patients with cardiac implantable electronic devices (CIEDs). This study aimed to examine the incidence, risk factors, and AF-related adverse outcomes of patients with CIEDs. Methods: This was an observational cohort study that analyzed patients without prevalent AF who underwent CIED implantation in 2009–2018 using a Korean nationwide claims database. The subjects were divided into three groups by CIED type and indication: pacemaker (n=21,438), implantable cardioverter defibrillator (ICD)/cardiac resynchronization therapy (CRT) with heart failure (HF) (n=3,450), and ICD for secondary prevention without HF (n=2,146). The incidence of AF, AF-associated predictors, and adverse outcomes were evaluated. Results: During follow-up, the incidence of AF was 4.3, 7.3, and 5.1 per 100 person-years in the pacemaker, ICD/CRT with HF, and ICD without HF cohorts, respectively. Across the three cohorts, older age and valvular heart disease were commonly associated with incident AF. Incident AF was consistently associated with an increased risk of ischemic stroke (3.8–11.4-fold), admission for HF (2.6–10.5-fold), hospitalization for any cause (2.4–2.7-fold), all-cause death (4.1–5.0-fold), and composite outcomes (3.4–5.7-fold). Oral anticoagulation rates were suboptimal in patients with incident AF (pacemaker, 51.3%; ICD/CRT with HF, 51.7%; and ICD without HF, 33.8%, respectively). Conclusions: A substantial proportion of patients implanted CIED developed newly diagnosed AF. Incident AF was associated with a higher risk of adverse events. The importance of awareness, early detection, and appropriate management of AF in patients with CIED should be emphasized.
연관 검색어 추천
이 검색어로 많이 본 자료
활용도 높은 자료
