Effectiveness and Safety of Contemporary Oral Anticoagulants Among Asians With Nonvalvular Atrial Fibrillation

Lee, So‐Ryoung; Choi, Eue Keun; Kwon, Soonil; Han, Kyung Do; Jung, Jae-Hun; Jin, Myung; Oh, Seil; Lip, Gregory Y.H.

doi:10.1161/strokeaha.119.025536

Cited by 83 publications

(123 citation statements)

References 11 publications

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“…Model 1 represents an unadjusted risk, and Model 2 was adjusted for age, sex, smoking status (never smoker, ex-smoker, or current smoker), alcohol intake (non, mild, or heavy drinker, g/day), regular exercise (performing > 30 minutes of moderate physical activity ≥ 5 times a week or > 20 minutes of vigorous physical activity ≥ 3 times a week), and low-income level (income in lower 20% among the entire Korean population of subjects supported by the medical aid program). [18] Model 3 was additionally adjusted for WC, systolic blood pressure, fasting glucose, logarithm of TG, and HDL-C levels.…”

Section: Discussionmentioning

confidence: 99%

Cumulative Burden of Metabolic Syndrome and Its Components on the Risk of Atrial Fibrillation: A Nationwide Population-based Study

Ahn

Choi

Jung

et al. 2020

Preprint

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Background: The metabolic syndrome (MetS) and its components are associated with the development of atrial fibrillation (AF). However, the impact of time-burden of MetS on the risk of AF is unknown. We investigated the effect of the cumulative longitudinal burden of MetS on the development of AF. Methods: We included 2 885 189 individuals without AF who underwent four annual health examinations during 2009–2013. Metabolic burdens were evaluated in the following three ways: (1) cumulative number of MetS diagnosed at each health examination (0–4 times); (2) cumulative number of each MetS component diagnosed at each health examination (0–4 times per MetS component); and (3) cumulative number of total MetS components diagnosed at each health examination (0 to a maximum of 20). The risk of AF according to the metabolic burden was estimated using Cox proportional-hazards models.Results: Of all individuals, 62.4%, 14.8%, 8.7%, 6.5%, and 7.6% met the MetS diagnostic criteria 0, 1, 2, 3, and 4 times, respectively. During a mean follow-up of 5.3 years, the risk of AF showed a positive association with the cumulative number of MetS diagnosed over four health examinations: adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) of 1, 2, 3, and 4 times compared to 0 times were 1.18 (1.13–1.24), 1.31 (1.25–1.39), 1.46 (1.38–1.55), and 1.72 (1.63–1.82), respectively; P for trend < 0.001. All five components of MetS, when diagnosed repeatedly, were independently associated with an increased risk of AF: adjusted HR (95% CI) from 1.22 (1.15–1.29) for impaired glucose intolerance to 1.96 (1.87–2.07) for elevated blood pressure. As metabolic components were accumulated from 0 to 20 counts, the risk of AF also gradually increased up to 3.1-fold (adjusted HR 3.11, 95% CI 2.52–3.83 in those with 20 cumulative components of MetS), however, recovery from MetS was linked to a decreased risk of AF. Conclusions: Given the positive correlations between the cumulative metabolic burdens and the risk of incident AF, maximal effort to detect and correct metabolic derangements even before MetS development might be important to prevent AF and related cardiovascular diseases.

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Section: Discussionmentioning

confidence: 99%

Cumulative Burden of Metabolic Syndrome and Its Components on the Risk of Atrial Fibrillation: A Nationwide Population-based Study

Ahn

Choi

Jung

et al. 2020

Preprint

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“…Covariates were designated based on diagnosis codes of ICD-10. The covariates considered in this study were diabetes, dyslipidemia, [14] myocardial infarction (MI), stroke, [18] heart failure, [16] liver disease, cancer, chronic obstructive pulmonary disease (COPD), [19] asthma, [20] end-stage renal disease (ESRD) with dialysis, [15] and immunocompromised status including autoimmune diseases and HIV infections. [21] Definitions of each comorbidity are presented in Table S1 in the Supplement.…”

Section: Definition Of Covariatesmentioning

confidence: 99%

“…[14][15][16][18][19][20][21] Also, considering the rigorous control of national health insurance system of South Korea in the diagnosis of COVID-19,…”

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confidence: 99%

Update on association between exposure to renin-angiotensin-aldosterone system inhibitors and coronavirus disease 2019 in South Korea

Seo

Son

2021

Korean J Intern Med

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Background/Aims Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, there have been concerns about the association between exposure to renin-angiotensin-aldosterone system (RAAS) inhibitors and the risk and severity of COVID-19. Methods We performed a case-control study that utilized up-to-date data on the South Korean population provided by the Korean National Health Insurance System. Of the 62,909 patients with hypertension or heart failure tested for COVID-19, there were 1,644 (2.6%) confirmed cases. After case-control matching, multivariable-adjusted conditional logistic regression analysis was performed. Results Comparison between patients exposed to RAAS inhibitors and those not exposed to RAAS inhibitors revealed that the adjusted odds ratio (OR) and 95% confidence interval (95% CI) for COVID-19 infection and death were 0.981 (0.849-1.135) and 0.875 (0.548-1.396), respectively. Subgroup analysis for the major confounders, age and region of diagnosis, resulted in OR and 95% CI of 0.912 (0.751-1.108) and 0.942 (0.791-1.121), respectively. Conclusions The present study demonstrated no evidence of association between RAAS inhibitor exposure and risk and severity of COVID-19.

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“…The main analyses were carried out with the above definition, and in addition to the hypertension criteria proposed by the Eighth Joint National Committee (JNC8) guidelines, we performed additional analysis on the hypertension criteria (SBP ≥ 130 mmHg or DBP ≥ 80 mmHg) recently proposed by the American College of Cardiology/American Heart Association (ACC/AHA). Furthermore, for sensitivity analysis, we used another definition of hypertension which includes ICD-10 codes for hypertension with admission ≥ 1 or outpatient department visit ≥ 2, and at least one prescription of anti-hypertensive drug per year 19 . The study population was followed from the day of health screening at index year to the date of incidence of hypertension, the date of death, or December 31, 2015, whichever came first.…”

Section: Study Outcomesmentioning

confidence: 99%

Association between hemoglobin variability and incidence of hypertension over 40 years: a Korean national cohort study

Son

Park

et al. 2020

Sci Rep

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Data source and study population. This study was approved by the Institutional Review Board of Gwangju Institute of Science and Technology (20190902-EX-02-02) and was performed based on the Declaration of Helsinki. Since the NHIS-Heals data was provided anonymously according to strict confidentiality guidelines, this study was exempted from receiving the subject's informed consent by Institutional Review Board of Gwangju Institute of Science and Technology. The NHIS database is registered with 98% of Koreans and includes all insurance claims. We analyzed the data using the health screening cohort, which was extracted from a random sampling of approximately 10% of a total 5 million people over 40 years received a health screening in 2002 or 2003. The NHIS provided a mandatory biennial general health screening for people over 40 years. The NHIS-HealS database includes demographic factors (sex, age, and income), hospital utilization (information about the use of medical facilities, admission date, and discharge date), and biennial health screening (height, weight, blood pressure, and blood tests). More information about the database can be found on the relevant website 13. The NHIS-HealS database has been used in many epidemiological studies and its validity is demonstrated elsewhere 14. This study was conducted with adults (age ≥ 40 years) who visited the health screening in 2006 or 2007 (index year) and had at least 3 health screenings from 2002 to 2007. Subjects meeting the criteria for the diagnosis of hypertension before the index year were excluded. Subjects with one or more missing values were also excluded.

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Effectiveness and Safety of Contemporary Oral Anticoagulants Among Asians With Nonvalvular Atrial Fibrillation

Cited by 83 publications

References 11 publications

Cumulative Burden of Metabolic Syndrome and Its Components on the Risk of Atrial Fibrillation: A Nationwide Population-based Study

Cumulative Burden of Metabolic Syndrome and Its Components on the Risk of Atrial Fibrillation: A Nationwide Population-based Study

Update on association between exposure to renin-angiotensin-aldosterone system inhibitors and coronavirus disease 2019 in South Korea

Association between hemoglobin variability and incidence of hypertension over 40 years: a Korean national cohort study

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