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  • 1
    Online Resource
    Online Resource
    Assessing major bleeding risk in atrial fibrillation patients concurrently taking non-vitamin K antagonist oral anticoagulants and antiepileptic drugs
    Oxford University Press (OUP) ; 2020
    In:  European Heart Journal - Cardiovascular Pharmacotherapy Vol. 6, No. 3 ( 2020-05-01), p. 147-154
    Details
    In: European Heart Journal - Cardiovascular Pharmacotherapy, Oxford University Press (OUP), Vol. 6, No. 3 ( 2020-05-01), p. 147-154
    Abstract: This study compared the risk of major bleeding between atrial fibrillation (AF) patients who took non-vitamin K antagonist oral anticoagulants (NOACs) and antiepileptic drugs (AEDs) concurrently and those who took only NOACs. Methods and results We performed a retrospective cohort study using Taiwan National Health Insurance database and included AF patients who received NOAC prescriptions from 1 June 2012 to 31 December 2017. The major bleeding risks of person-quarters exposed to NOAC and 11 concurrent AEDs (carbamazepine, gabapentin, lamotrigine, levetiracetam, oxcarbazepine, phenobarbital, phenytoin, pregabalin, topiramate, valproic acid, and zonisamide) were compared with person-quarters exposed to NOAC alone. Adjusted incidence rate differences between NOAC with or without concurrent AEDs were estimated using Poisson regression models weighted by the inverse probability of treatment. Among 104 319 patients (age 75.0 ± 10.3 years; men, 56.2%), 8546 major bleeding events occurred during 731 723 person-quarters with NOAC prescriptions. Concurrent AED use was found in 15.3% of NOAC-treated patients. Concurrent use of NOAC with valproic acid, phenytoin, or levetiracetam increased adjusted incidence rates per 1000 person-years of major bleeding more significantly than NOAC alone: 153.49 for NOAC plus valproic acid vs. 55.06 for NOAC alone [difference 98.43, 95% confidence interval (CI) 82.37–114.49]; 135.83 for NOAC plus phenytoin vs. 54.43 for NOAC alone (difference 81.4, 95% CI 60.14–102.66); and 132.96 for NOAC plus levetiracetam vs. 53.08 for NOAC alone (difference 79.88, 95% CI 64.47–95.30). Conclusion For AF patients, the concurrent use of NOACs and valproic acid, phenytoin, or levetiracetam was associated with a higher risk of major bleeding.
    Type of Medium: Online Resource
    ISSN: 2055-6837 , 2055-6845
    URL: Article
    DOI: 10.1093/ehjcvp/pvz035
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2808613-2
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  • 2
    Online Resource
    Online Resource
    Abstract 11146: Cardiovascular Outcomes in Patients with Atrial Fibrillation Using Dronedarone and Non-Dronedarone Antiarrhythmic Drugs
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Circulation Vol. 144, No. Suppl_1 ( 2021-11-16)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 144, No. Suppl_1 ( 2021-11-16)
    Abstract: Introduction: Dronedarone was developed to improve outcomes in patients with atrial fibrillation (AF) compared with other antiarrhythmic drugs. Hypothesis: Dronedarone may offer better cardiovascular outcomes compared to non-dronedarone antiarrhythmic drugs. Methods: Taiwan National Health Insurance Research Database were retrieved between 2012-2017 for patients with AF. Patients not taking antiarrhythmic drugs, having history of bradycardia, heart block, heart failure admission, mitral stenosis, prosthetic valve, incomplete demographic data, and follow-up less than 3 months were excluded. Protocol 1, outcomes of patients with AF using dronedarone were compared to non-dronedarone antiarrhythmic drugs (amiodarone, propafenone, flecainide, sotalol). In Protocol 2, outcomes of patients with AF using dronedarone were compared to amiodarone, the most frequently used antiarrhythmic drug. Propensity score matching performed to reduce bias. Primary outcomes were acute myocardial infarction (AMI), ischemic stroke/systemic embolism (IS/SE), intracranial hemorrhage (ICH), major bleeding, cardiovascular death, and all-cause mortality. Secondary outcome was composite of AMI, ischemic stroke, and cardiovascular death (MACE). Results: In Protocol 1, after 1:3 matching, 2,032 dronedarone patients and 6,096 non-dronedarone patients were analyzed. Dronedarone was associated with significantly lower IS/SE (p=0.0033), ICH (p=0.0111), major bleeding (p=0.0230), cardiovascular death (p 〈 0.0001), all-cause mortality (p 〈 0.0001) and MACE (p 〈 0.0001), without difference in AMI, compared to non-dronedarone. In Protocol 2, after 1:3 matching, 1,994 dronedarone patients and 5,982 amiodarone patients were analyzed. Dronedarone was associated with significantly lower IS/SE (p=0.0071), cardiovascular death (p 〈 0.0001), all-cause mortality (p 〈 0.0001), and MACE (p 〈 0.0001), without differences in AMI, ICH, and major bleeding, compared to amiodarone. Use of anticoagulants and doses were similar between groups in both protocols. Conclusions: Dronedarone was associated with lower ischemic stroke/systemic embolism, cardiovascular death, all-cause mortality and MACE compared to non-dronedarone or directly to amiodarone.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.144.suppl_1.11146
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 1466401-X
    detail.hit.zdb_id: 80099-5
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  • 3
    Online Resource
    Online Resource
    Bleeding associated with co-administration of clopidogrel and ACEi in patients undergoing PCI and DAPT
    Elsevier BV ; 2021
    In:  Atherosclerosis Vol. 324 ( 2021-05), p. 76-83
    Details
    In: Atherosclerosis, Elsevier BV, Vol. 324 ( 2021-05), p. 76-83
    Type of Medium: Online Resource
    ISSN: 0021-9150
    URL: Article
    DOI: 10.1016/j.atherosclerosis.2021.03.022
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 80061-2
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  • 4
    Online Resource
    Online Resource
    Cardiovascular outcomes in patients with atrial fibrillation concomitantly treated with antiarrhythmic drugs and non-vitamin k antagonist oral anticoagulants
    Oxford University Press (OUP) ; 2023
    In:  Europace Vol. 25, No. 5 ( 2023-05-19)
    Details
    In: Europace, Oxford University Press (OUP), Vol. 25, No. 5 ( 2023-05-19)
    Abstract: Limited data compared antiarrhythmic drugs (AADs) with concomitant non-vitamin K antagonist oral anticoagulants in atrial fibrillation patients, hence the aim of the study. Methods and results National health insurance database were retrieved during 2012–17 for study. We excluded patients not taking AADs, bradycardia, heart block, heart failure admission, mitral stenosis, prosthetic valve, incomplete demographic data, and follow-up & lt;3 months. Outcomes were compared in Protocol 1, dronedarone vs. non-dronedarone; Protocol 2, dronedarone vs. amiodarone; and Protocol 3, dronedarone vs. propafenone. Outcomes were acute myocardial infarction (AMI), ischaemic stroke/systemic embolism, intracranial haemorrhage (ICH), major bleeding, cardiovascular death, all-cause mortality, and major adverse cardiovascular event (MACE) (including AMI, ischaemic stroke, and cardiovascular death). In Protocol 1, 2298 dronedarone users and 6984 non-dronedarone users (amiodarone = 4844; propafenone = 1914; flecainide = 75; sotalol = 61) were analysed. Dronedarone was associated with lower ICH (HR = 0.61, 95% CI = 0.38–0.99, P = 0.0436), cardiovascular death (HR = 0.24, 95% CI = 0.16–0.37, P & lt; 0.0001), all-cause mortality (HR = 0.33, 95% CI = 0.27–0.42, P & lt; 0.0001), and MACE (HR = 0.56, 95% CI = 0.45–0.70, P & lt; 0.0001). In Protocol 2, 2231 dronedarone users and 6693 amiodarone users were analysed. Dronedarone was associated with significantly lower ICH (HR = 0.53, 95%=CI 0.33–0.84, P = 0.0078), cardiovascular death (HR = 0.20, 95% CI = 0.13–0.31, P & lt; 0.0001), all-cause mortality (HR 0.27, 95% CI 0.22–0.34, P & lt; 0.0001), and MACE (HR = 0.53, 95% CI = 0.43–0.66, P & lt; 0.0001), compared with amiodarone. In Protocol 3, 812 dronedarone users and 2436 propafenone users were analysed. There were no differences between two drugs for primary and secondary outcomes. Conclusion The use of dronedarone with NOACs was associated with cardiovascular benefits in an Asian population, compared with non-dronedarone AADs and amiodarone.
    Type of Medium: Online Resource
    ISSN: 1099-5129 , 1532-2092
    URL: Article
    DOI: 10.1093/europace/euad083
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 1449879-0
    detail.hit.zdb_id: 2002579-8
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  • 5
    Online Resource
    Online Resource
    Abstract 11285: Non-Vitamin K Antagonist Oral Anticoagulant Drug-Drug Interactions in Patients with Atrial Fibrillation Using Dronedarone and Non-Dronedarone Antiarrhythmic Drugs
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Circulation Vol. 144, No. Suppl_1 ( 2021-11-16)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 144, No. Suppl_1 ( 2021-11-16)
    Abstract: Introduction: Non-vitamin K antagonist oral anticoagulant (NOAC) do not normally require INR-monitoring. We aimed to investigate drug-drug interactions of NOACs in patients with atrial fibrillation (AF) using antiarrhythmic drugs. Hypothesis: Dronedarone may have less drug-drug interaction compared to non-dronedarone antiarrhythmic drugs. Methods: National Health Insurance Research Database were retrieved between 2012 and 2017 for patients with AF. We excluded patients not taking antiarrhythmic drugs, bradycardia, heart block, history of heart failure, mitral stenosis, prosthetic valve, incomplete demographic data, and follow-up 〈 3 months. Primary outcomes were major bleeding, intracranial hemorrhage, and gastrointestinal bleeding. Results: In total, 84,933 patients used NOAC in patients with AF were enrolled. After exclusion criteria, there were 26,773 patients with 204,937 person-quarters remained for analysis after the exclusion criteria were applied In terms of major bleeding, there was no increased major bleeding due to DDI between NOAC and dronedarone (adjusted rate ratio [aRR]: 0.77, 99% confidence interval [CI] : 0.54-1.12, p = 0.074). In terms of intracranial hemorrhage, there was no increased major bleeding due to DDI between NOAC and dronedarone (aRR: 0.64, 99% CI: 0.34-1.20, p = 0.0668). In terms of gastrointestinal bleeding, there was no increased major bleeding due to DDI between NOAC and dronedarone (aRR: 0.86, 99% CI: 0.55-1.35, p = 0.3819). Conclusions: In this study, NOACs and dronedarone coprescription is not associated with an increased risk of major bleeding, intracranial hemorrhage, nor gastrointestinal bleeding. The results suggest that such NOAC with dronedarone coprescription should be practiced in place of NOAC with amiodarone when the clinical criteria are appropriate.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.144.suppl_1.11285
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 1466401-X
    detail.hit.zdb_id: 80099-5
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  • 6
    Online Resource
    Online Resource
    Electrocardiographic changes associated with SGLT2 inhibitors and non-SGLT2 inhibitors: A multi-center retrospective study
    Frontiers Media SA ; 2022
    In:  Frontiers in Cardiovascular Medicine Vol. 9 ( 2022-9-6)
    Details
    In: Frontiers in Cardiovascular Medicine, Frontiers Media SA, Vol. 9 ( 2022-9-6)
    Abstract: Sodium-glucose co-transporter 2 (SGLT2) inhibitors has been shown with cardiovascular benefit in type 2 diabetes mellitus (T2DM) patients. However, its osmotic diuresis still concern physicians who may look for possible electrolyte imbalance. We therefore aimed to investigate electrocardiographic (ECG) changes associated with SGLT2 inhibitors. Methods Electronic medical records from Chang Gung Research Database between January 1, 2001 and January 31, 2019 were searched for patients with ECG reports and patients on an oral hypoglycemic agent (OHA). We then separate these T2DM patients with EKG into those taking either SGLT2 inhibitors or non-SGLT2 inhibitors. We excluded patients with OHA use & lt;28 days, age & lt;18 years, baseline ECG QTc & gt; 500 ms, and ECG showing atrial fibrillation or atrial flutter. Propensity score matching (PSM) was performed between groups by age, sex, comorbidities, and medications (including QT prolonging medications). Conditional logistic regression and Firth's logistic regression for rare events were employed to compare the difference between SGLT2 and non-SGLT2 inhibitor patients. Results After exclusion criteria and PSM, there remained 1,056 patients with ECG on SGLT2 inhibitors and 2,119 patients with ECG on non-SGLT2 inhibitors in the study. There were no differences in PR intervals, QT prolongations by Bazett's or Fridericia's formulas, new onset ST-T changes, new onset CRBBB or CLBBB, and ventricular arrhythmia between the group of patients on SGLT2 inhibitors and the group of patients on non-SGLT2 inhibitors. There were no differences between the two groups in terms of cardiovascular death and sudden cardiac death. In addition, there were no differences between the two groups in terms of electrolytes. Conclusions Compared with T2DM patients on non-SGLT2 inhibitors, there were no differences in PR interval, QT interval, ST-T changes, bundle-branch block, or ventricular arrhythmia in the patients on SGLT2 inhibitors. There were no differences in cardiovascular mortality between these two groups. In addition, there were no electrolyte differences between groups. SGLT2 inhibitors appeared to be well-tolerated in terms of cardiovascular safety.
    Type of Medium: Online Resource
    ISSN: 2297-055X
    URL: Article
    DOI: 10.3389/fcvm.2022.934193
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2022
    detail.hit.zdb_id: 2781496-8
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  • 7
    Online Resource
    Online Resource
    datasheet1.docx
    Frontiers Media SA ; 2021
    In:  Frontiers in Pharmacology Vol. 12 ( 2021-4-15)
    Details
    In: Frontiers in Pharmacology, Frontiers Media SA, Vol. 12 ( 2021-4-15)
    Abstract: Background: Dipeptidylpeptidase-4 inhibitors (DPP-4i′s) are considered to be safe for patients with type 2 diabetes mellitus (T2DM). However, little is known about drug–drug interactions between DPP-4i′s and concurrent medications. Methods: Data on patients using DPP-4i′s for T2DM during 2011–2017 were retrieved from Chang Gung Research database provided by Chang Gung Memorial Hospital. Patients were excluded if they were aged & lt;30 years or & gt;90 years; had incomplete demographic data; had insulinoma; or had records of concomitant insulin use. A generalized estimating equation–based Poisson model was employed for statistical analysis. The primary outcome was hypoglycemia events. Results: We retrieved data on a total of 97,227 patients using DPP-4i′s. After patients were excluded according to the mentioned criteria, the remaining 77,047 DPP-4i users were studied (mean age 64 ± 12 years, men 54.4%). The most common medications coprescribed with DPP4is over all person-quarters were acetaminophen, simvastatin, fluvastatin, and colchicine (all & gt;20,000 person-quarters). The combinations of a DPP-4i with bumetanide, captopril, colchicine, acetaminophen, cotrimoxazole, and pantoprazole were associated with an increased risk of hypoglycemia. Compared with the ratios observed for person-quarters of DPP-4i use alone (reference category), the adjusted prevalence ratios per 100 person-years of hypoglycemia for person-quarters of DPP-4i use in combination with bumetanide, captopril, colchicine, acetaminophen, cotrimoxazole, and pantoprazole were 2.44 (95% confidence interval [CI], 1.78–3.36), 2.97 (95% CI, 2.26–3.90), 1.87 (95% CI, 1.44–2.42), 2.83 (95% CI, 2.44–3.29), 2.27 (95% CI, 1.27–4.04), and 3.03 (95% CI, 1.96–4.68), respectively. Conclusion: Among patients taking DPP-4i′s for T2DM, concurrent use of such inhibitors with bumetanide, captopril, acetaminophen, and pantoprazole was associated with an increased risk of hypoglycemia compared with the use of DPP-4i′s alone. Physicians prescribing DPP-4i′s should consider the potential risks associated with their concomitant use with other drugs.
    Type of Medium: Online Resource
    ISSN: 1663-9812
    URL: Article
    URL: Article
    DOI: 10.3389/fphar.2021.570835
    DOI: 10.3389/fphar.2021.570835.s001
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2021
    detail.hit.zdb_id: 2587355-6
    SSG: 15,3
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  • 8
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    Familial aggregation of nasopharyngeal carcinoma in Taiwan
    Elsevier BV ; 2017
    In:  Oral Oncology Vol. 73 ( 2017-10), p. 10-15
    Details
    In: Oral Oncology, Elsevier BV, Vol. 73 ( 2017-10), p. 10-15
    Type of Medium: Online Resource
    ISSN: 1368-8375
    URL: Article
    DOI: 10.1016/j.oraloncology.2017.07.020
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2017
    detail.hit.zdb_id: 1120465-5
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