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17.03.2021 | Original Article

Proton Pump Inhibitor Co-Therapy in Patients with Atrial Fibrillation Treated with Oral Anticoagulants and a Prior History of Upper Gastrointestinal Tract Bleeding

verfasst von: So-Ryoung Lee, Soonil Kwon, Eue-Keun Choi, Jin-Hyung Jung, Kyung-Do Han, Seil Oh, Gregory Y. H. Lip

Erschienen in: Cardiovascular Drugs and Therapy | Ausgabe 4/2022

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Abstract

Purpose

The risk of gastrointestinal bleeding (GIB) can be mitigated by proton pump inhibitor (PPI) co-therapy in patients with atrial fibrillation (AF) treated with anticoagulants. We aimed to evaluate the effect of PPIs on the risk of GIB in Asian patients with AF, treated with oral anticoagulants (OACs), and with a prior history of upper GIB.

Methods

Using a nationwide claims database, OAC-naïve patients with AF and a history of upper GIB before initiating OAC treatment between January 2010 and April 2018 were included. Patients were categorized into 10 groups according to the index OAC (warfarin, rivaroxaban, dabigatran, apixaban, and edoxaban) and whether or not they received PPI co-therapy, and were followed up for incidence of major GIB.

Results

Among a total of 42,048 patients, 40% were prescribed PPIs as co-therapy with OACs. Over a median 0.6 years (interquartile ranges 0.2–1.7 years) of follow-up, rivaroxaban use without PPIs showed the highest crude incidence of major GIB (2.62 per 100 person-years), followed by the use of warfarin without a PPI (2.20 per 100 person-years). Compared to the patients without PPI use, PPI co-therapy was associated with a significantly lower risk of major GIB, by 40% and 36%, in the rivaroxaban and warfarin groups, respectively. In dabigatran, apixaban, and edoxaban users, PPI co-therapy did not show a significant reduction in the risk of major GIB.

Conclusion

Among patients with AF receiving anticoagulant treatment and with a prior history of upper GIB, PPI co-therapy was associated with a significant reduction in the risk of major GIB in patients treated with rivaroxaban and warfarin.
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Literatur
1.
Zurück zum Zitat Lip GYH, Freedman B, De Caterina R, Potpara TS. Stroke prevention in atrial fibrillation: past, present and future. Comparing the guidelines and practical decision-making. Thromb Haemost. 2017;117(7):1230–9.PubMedCrossRef Lip GYH, Freedman B, De Caterina R, Potpara TS. Stroke prevention in atrial fibrillation: past, present and future. Comparing the guidelines and practical decision-making. Thromb Haemost. 2017;117(7):1230–9.PubMedCrossRef
2.
Zurück zum Zitat Ruff CT, Giugliano RP, Braunwald E, Hoffman EB, Deenadayalu N, Ezekowitz MD, et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet. 2014;383(9921):955–62.PubMedCrossRef Ruff CT, Giugliano RP, Braunwald E, Hoffman EB, Deenadayalu N, Ezekowitz MD, et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet. 2014;383(9921):955–62.PubMedCrossRef
3.
Zurück zum Zitat Lamberts M, Staerk L, Olesen JB, et al. Major Bleeding Complications and Persistence With Oral Anticoagulation in Non-Valvular Atrial Fibrillation: Contemporary Findings in Real-Life Danish Patients. J Am Heart Assoc 2017;6(2). Lamberts M, Staerk L, Olesen JB, et al. Major Bleeding Complications and Persistence With Oral Anticoagulation in Non-Valvular Atrial Fibrillation: Contemporary Findings in Real-Life Danish Patients. J Am Heart Assoc 2017;6(2).
4.
Zurück zum Zitat O'Brien EC, Holmes DN, Thomas LE, et al. Prognostic significance of nuisance bleeding in anticoagulated patients with atrial fibrillation. Circulation. 2018;138(9):889–97.PubMedCrossRef O'Brien EC, Holmes DN, Thomas LE, et al. Prognostic significance of nuisance bleeding in anticoagulated patients with atrial fibrillation. Circulation. 2018;138(9):889–97.PubMedCrossRef
5.
Zurück zum Zitat Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361(12):1139–51.PubMedCrossRef Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361(12):1139–51.PubMedCrossRef
7.
Zurück zum Zitat Giugliano RP, Ruff CT, Braunwald E, et al. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2013;369(22):2093–104.PubMedCrossRef Giugliano RP, Ruff CT, Braunwald E, et al. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2013;369(22):2093–104.PubMedCrossRef
8.
Zurück zum Zitat Shen AY, Yao JF, Brar SS, Jorgensen MB, Chen W. Racial/ethnic differences in the risk of intracranial hemorrhage among patients with atrial fibrillation. J Am Coll Cardiol. 2007;50(4):309–15.PubMedCrossRef Shen AY, Yao JF, Brar SS, Jorgensen MB, Chen W. Racial/ethnic differences in the risk of intracranial hemorrhage among patients with atrial fibrillation. J Am Coll Cardiol. 2007;50(4):309–15.PubMedCrossRef
9.
Zurück zum Zitat Lee SR, Choi EK, Han KD, Cha MJ, Oh S, Lip GYH. Temporal trends of antithrombotic therapy for stroke prevention in Korean patients with non-valvular atrial fibrillation in the era of non-vitamin K antagonist oral anticoagulants: a nationwide population-based study. PLoS One. 2017;12(12):e0189495.PubMedPubMedCentralCrossRef Lee SR, Choi EK, Han KD, Cha MJ, Oh S, Lip GYH. Temporal trends of antithrombotic therapy for stroke prevention in Korean patients with non-valvular atrial fibrillation in the era of non-vitamin K antagonist oral anticoagulants: a nationwide population-based study. PLoS One. 2017;12(12):e0189495.PubMedPubMedCentralCrossRef
10.
Zurück zum Zitat Chan EW, Lau WC, Leung WK, et al. Prevention of dabigatran-related gastrointestinal bleeding with gastroprotective agents: a population-based study. Gastroenterology. 2015;149(3):586–95.PubMedCrossRef Chan EW, Lau WC, Leung WK, et al. Prevention of dabigatran-related gastrointestinal bleeding with gastroprotective agents: a population-based study. Gastroenterology. 2015;149(3):586–95.PubMedCrossRef
11.
Zurück zum Zitat Steffel J, Verhamme P, Potpara TS, et al. The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: executive summary. Europace. 2018;20(8):1231–42.PubMedCrossRef Steffel J, Verhamme P, Potpara TS, et al. The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: executive summary. Europace. 2018;20(8):1231–42.PubMedCrossRef
12.
Zurück zum Zitat Ray WA, Chung CP, Murray KT, et al. Association of proton pump inhibitors with reduced risk of warfarin-related serious upper gastrointestinal bleeding. Gastroenterology. 2016;151(6):1105–12.PubMedCrossRef Ray WA, Chung CP, Murray KT, et al. Association of proton pump inhibitors with reduced risk of warfarin-related serious upper gastrointestinal bleeding. Gastroenterology. 2016;151(6):1105–12.PubMedCrossRef
13.
Zurück zum Zitat Wang KL, Lip GYH, Lin SJ, Chiang CE. Non-vitamin K antagonist oral anticoagulants for stroke prevention in Asian patients with nonvalvular atrial fibrillation: meta-analysis. Stroke. 2015;46(9):2555–61.PubMedPubMedCentralCrossRef Wang KL, Lip GYH, Lin SJ, Chiang CE. Non-vitamin K antagonist oral anticoagulants for stroke prevention in Asian patients with nonvalvular atrial fibrillation: meta-analysis. Stroke. 2015;46(9):2555–61.PubMedPubMedCentralCrossRef
14.
Zurück zum Zitat Lip GYH, Wang KL, Chiang CE. Non-vitamin K antagonist oral anticoagulants (NOACs) for stroke prevention in Asian patients with atrial fibrillation: time for a reappraisal. Int J Cardiol. 2015;180:246–54.PubMedCrossRef Lip GYH, Wang KL, Chiang CE. Non-vitamin K antagonist oral anticoagulants (NOACs) for stroke prevention in Asian patients with atrial fibrillation: time for a reappraisal. Int J Cardiol. 2015;180:246–54.PubMedCrossRef
15.
Zurück zum Zitat Abraham NS, Noseworthy PA, Yao X, Sangaralingham LR, Shah ND. Gastrointestinal safety of direct oral anticoagulants: a large population-based study. Gastroenterology. 2017;152(5):1014–22 e1.PubMedCrossRef Abraham NS, Noseworthy PA, Yao X, Sangaralingham LR, Shah ND. Gastrointestinal safety of direct oral anticoagulants: a large population-based study. Gastroenterology. 2017;152(5):1014–22 e1.PubMedCrossRef
16.
Zurück zum Zitat Lee SR, Choi EK, Kwon S, et al. Effectiveness and safety of contemporary oral anticoagulants among Asians with nonvalvular atrial fibrillation. Stroke. 2019;50(8):2245–9.PubMedCrossRef Lee SR, Choi EK, Kwon S, et al. Effectiveness and safety of contemporary oral anticoagulants among Asians with nonvalvular atrial fibrillation. Stroke. 2019;50(8):2245–9.PubMedCrossRef
17.
Zurück zum Zitat Ray WA, Chung CP, Murray KT, et al. Association of oral anticoagulants and proton pump inhibitor cotherapy with hospitalization for upper gastrointestinal tract bleeding. JAMA. 2018;320(21):2221–30.PubMedPubMedCentralCrossRef Ray WA, Chung CP, Murray KT, et al. Association of oral anticoagulants and proton pump inhibitor cotherapy with hospitalization for upper gastrointestinal tract bleeding. JAMA. 2018;320(21):2221–30.PubMedPubMedCentralCrossRef
18.
Zurück zum Zitat Joo MK, Park CH, Kim JS, Park JM, Ahn JY, Lee BE, et al. Clinical guidelines for drug-induced peptic ulcer, 2020 revised edition. Korean J Gastroenterol. 2020;76(3):108–33.PubMedCrossRef Joo MK, Park CH, Kim JS, Park JM, Ahn JY, Lee BE, et al. Clinical guidelines for drug-induced peptic ulcer, 2020 revised edition. Korean J Gastroenterol. 2020;76(3):108–33.PubMedCrossRef
19.
Zurück zum Zitat Kim JS, Kim BW, Kim DH, et al. Guidelines for non-variceal upper gastrointestinal bleeding. Korean J Gastroenterol. 2020;75(6):322–32.PubMedCrossRef Kim JS, Kim BW, Kim DH, et al. Guidelines for non-variceal upper gastrointestinal bleeding. Korean J Gastroenterol. 2020;75(6):322–32.PubMedCrossRef
20.
Zurück zum Zitat Song SO, Jung CH, Song YD, et al. Background and data configuration process of a nationwide population-based study using the Korean national health insurance system. Diabetes Metab J. 2014;38(5):395–403.PubMedPubMedCentralCrossRef Song SO, Jung CH, Song YD, et al. Background and data configuration process of a nationwide population-based study using the Korean national health insurance system. Diabetes Metab J. 2014;38(5):395–403.PubMedPubMedCentralCrossRef
21.
Zurück zum Zitat Seong SC, Kim YY, Khang YH, et al. Data resource profile: the National Health Information Database of the National Health Insurance Service in South Korea. Int J Epidemiol. 2017;46(3):799–800. Seong SC, Kim YY, Khang YH, et al. Data resource profile: the National Health Information Database of the National Health Insurance Service in South Korea. Int J Epidemiol. 2017;46(3):799–800.
22.
Zurück zum Zitat Lee SR, Choi EK, Han KD, Cha MJ, Oh S. Trends in the incidence and prevalence of atrial fibrillation and estimated thromboembolic risk using the CHA2DS2-VASc score in the entire Korean population. Int J Cardiol. 2017;236:226–31.PubMedCrossRef Lee SR, Choi EK, Han KD, Cha MJ, Oh S. Trends in the incidence and prevalence of atrial fibrillation and estimated thromboembolic risk using the CHA2DS2-VASc score in the entire Korean population. Int J Cardiol. 2017;236:226–31.PubMedCrossRef
23.
Zurück zum Zitat Lip GYH, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the Euro Heart Survey on Atrial Fibrillation. Chest. 2010;137(2):263–72.PubMedCrossRef Lip GYH, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the Euro Heart Survey on Atrial Fibrillation. Chest. 2010;137(2):263–72.PubMedCrossRef
24.
Zurück zum Zitat Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GYH. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest. 2010;138(5):1093–100.PubMedCrossRef Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GYH. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest. 2010;138(5):1093–100.PubMedCrossRef
25.
Zurück zum Zitat Quan H, Sundararajan V, Halfon P, et al. Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care. 2005;43(11):1130–9.PubMedCrossRef Quan H, Sundararajan V, Halfon P, et al. Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care. 2005;43(11):1130–9.PubMedCrossRef
26.
Zurück zum Zitat Cho MS, Yun JE, Park JJ, et al. Outcomes after use of standard- and low-dose non-vitamin K oral anticoagulants in Asian patients with atrial fibrillation [published online December 3, 2018]. Stroke. Cho MS, Yun JE, Park JJ, et al. Outcomes after use of standard- and low-dose non-vitamin K oral anticoagulants in Asian patients with atrial fibrillation [published online December 3, 2018]. Stroke.
27.
Zurück zum Zitat Granger CB, Alexander JH, McMurray JJV, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365(11):981–92.PubMedCrossRef Granger CB, Alexander JH, McMurray JJV, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365(11):981–92.PubMedCrossRef
28.
Zurück zum Zitat Chan YH, Lee HF, See LC, et al. Effectiveness and safety of four direct oral anticoagulants in Asian patients with nonvalvular atrial fibrillation. Chest. 2019;156(3):529–43.PubMedCrossRef Chan YH, Lee HF, See LC, et al. Effectiveness and safety of four direct oral anticoagulants in Asian patients with nonvalvular atrial fibrillation. Chest. 2019;156(3):529–43.PubMedCrossRef
29.
Zurück zum Zitat Fock KM, Ang TL. Epidemiology of Helicobacter pylori infection and gastric cancer in Asia. J Gastroenterol Hepatol. 2010;25(3):479–86.PubMedCrossRef Fock KM, Ang TL. Epidemiology of Helicobacter pylori infection and gastric cancer in Asia. J Gastroenterol Hepatol. 2010;25(3):479–86.PubMedCrossRef
30.
Zurück zum Zitat Li Z, Zou D, Ma X, et al. Epidemiology of peptic ulcer disease: endoscopic results of the systematic investigation of gastrointestinal disease in China. Am J Gastroenterol. 2010;105(12):2570–7.PubMedCrossRef Li Z, Zou D, Ma X, et al. Epidemiology of peptic ulcer disease: endoscopic results of the systematic investigation of gastrointestinal disease in China. Am J Gastroenterol. 2010;105(12):2570–7.PubMedCrossRef
31.
Zurück zum Zitat Hooi JKY, Lai WY, Ng WK, et al. Global prevalence of helicobacter pylori infection: systematic review and meta-analysis. Gastroenterology. 2017;153(2):420–9.PubMedCrossRef Hooi JKY, Lai WY, Ng WK, et al. Global prevalence of helicobacter pylori infection: systematic review and meta-analysis. Gastroenterology. 2017;153(2):420–9.PubMedCrossRef
32.
Zurück zum Zitat Papatheodoridis GV, Papadelli D, Cholongitas E, Vassilopoulos D, Mentis A, Hadziyannis SJ. Effect of helicobacter pylori infection on the risk of upper gastrointestinal bleeding in users of nonsteroidal anti-inflammatory drugs. Am J Med. 2004;116(9):601–5.PubMedCrossRef Papatheodoridis GV, Papadelli D, Cholongitas E, Vassilopoulos D, Mentis A, Hadziyannis SJ. Effect of helicobacter pylori infection on the risk of upper gastrointestinal bleeding in users of nonsteroidal anti-inflammatory drugs. Am J Med. 2004;116(9):601–5.PubMedCrossRef
33.
Zurück zum Zitat Nahon S, Hagège H, Latrive JP, et al. Epidemiological and prognostic factors involved in upper gastrointestinal bleeding: results of a French prospective multicenter study. Endoscopy. 2012;44(11):998–1008.PubMedCrossRef Nahon S, Hagège H, Latrive JP, et al. Epidemiological and prognostic factors involved in upper gastrointestinal bleeding: results of a French prospective multicenter study. Endoscopy. 2012;44(11):998–1008.PubMedCrossRef
34.
Zurück zum Zitat Barkun AN, Almadi M, Kuipers EJ, et al. Management of nonvariceal upper gastrointestinal bleeding: guideline recommendations from the International Consensus Group. Ann Intern Med. 2019;171(11):805–22.PubMedPubMedCentralCrossRef Barkun AN, Almadi M, Kuipers EJ, et al. Management of nonvariceal upper gastrointestinal bleeding: guideline recommendations from the International Consensus Group. Ann Intern Med. 2019;171(11):805–22.PubMedPubMedCentralCrossRef
35.
Zurück zum Zitat Moayyedi P, Eikelboom JW, Bosch J, et al. Pantoprazole to prevent gastroduodenal events in patients receiving rivaroxaban and/or aspirin in a randomized, double-blind, placebo-controlled trial. Gastroenterology. 2019;157(2):403–12.PubMedCrossRef Moayyedi P, Eikelboom JW, Bosch J, et al. Pantoprazole to prevent gastroduodenal events in patients receiving rivaroxaban and/or aspirin in a randomized, double-blind, placebo-controlled trial. Gastroenterology. 2019;157(2):403–12.PubMedCrossRef
36.
Zurück zum Zitat Holster IL, Valkhoff VE, Kuipers EJ, Tjwa ETTL. New oral anticoagulants increase risk for gastrointestinal bleeding: a systematic review and meta-analysis. Gastroenterology. 2013;145(1):105–112.e15.PubMedCrossRef Holster IL, Valkhoff VE, Kuipers EJ, Tjwa ETTL. New oral anticoagulants increase risk for gastrointestinal bleeding: a systematic review and meta-analysis. Gastroenterology. 2013;145(1):105–112.e15.PubMedCrossRef
37.
Zurück zum Zitat Kwon S, Lee SR, Choi EK, Lee E, Jung JH, Han KD, et al. Non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation and prior gastrointestinal bleeding. Stroke. 2021;52(2):511–20.PubMedCrossRef Kwon S, Lee SR, Choi EK, Lee E, Jung JH, Han KD, et al. Non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation and prior gastrointestinal bleeding. Stroke. 2021;52(2):511–20.PubMedCrossRef
38.
Zurück zum Zitat Anghel L, Sascau R, Trifan A, Zota IM, Statescu C. Non-Vitamin K Antagonist Oral Anticoagulants and the Gastrointestinal Bleeding Risk in Real-World Studies. J Clin Med 2020;9(5). Anghel L, Sascau R, Trifan A, Zota IM, Statescu C. Non-Vitamin K Antagonist Oral Anticoagulants and the Gastrointestinal Bleeding Risk in Real-World Studies. J Clin Med 2020;9(5).
39.
Zurück zum Zitat Lin S, Wang Y, Zhang L, Guan W. Dabigatran must be used carefully: literature review and recommendations for management of adverse events. Drug Des Devel Ther. 2019;13:1527–33.PubMedPubMedCentralCrossRef Lin S, Wang Y, Zhang L, Guan W. Dabigatran must be used carefully: literature review and recommendations for management of adverse events. Drug Des Devel Ther. 2019;13:1527–33.PubMedPubMedCentralCrossRef
40.
Zurück zum Zitat Cheung KS, Leung WK. Gastrointestinal bleeding in patients on novel oral anticoagulants: risk, prevention and management. World J Gastroenterol. 2017;23(11):1954–63.PubMedPubMedCentralCrossRef Cheung KS, Leung WK. Gastrointestinal bleeding in patients on novel oral anticoagulants: risk, prevention and management. World J Gastroenterol. 2017;23(11):1954–63.PubMedPubMedCentralCrossRef
41.
Zurück zum Zitat Wang KL, Lopes RD, Patel MR, et al. Efficacy and safety of reduced-dose non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: a meta-analysis of randomized controlled trials. Eur Heart J. 2019;40(19):1492–500.PubMedCrossRef Wang KL, Lopes RD, Patel MR, et al. Efficacy and safety of reduced-dose non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: a meta-analysis of randomized controlled trials. Eur Heart J. 2019;40(19):1492–500.PubMedCrossRef
42.
Zurück zum Zitat Lee SR, Lee YS, Park JS, et al. Label adherence for non-vitamin K antagonist oral anticoagulants in a prospective cohort of Asian patients with atrial fibrillation. Yonsei Med J. 2019;60:277–84.PubMedPubMedCentralCrossRef Lee SR, Lee YS, Park JS, et al. Label adherence for non-vitamin K antagonist oral anticoagulants in a prospective cohort of Asian patients with atrial fibrillation. Yonsei Med J. 2019;60:277–84.PubMedPubMedCentralCrossRef
43.
Zurück zum Zitat Lee SR, Lee HJ, Choi EK, et al. Direct oral anticoagulants in patients with atrial fibrillation and liver disease. J Am Coll Cardiol. 2019;73(25):3295–308.PubMedCrossRef Lee SR, Lee HJ, Choi EK, et al. Direct oral anticoagulants in patients with atrial fibrillation and liver disease. J Am Coll Cardiol. 2019;73(25):3295–308.PubMedCrossRef
44.
Zurück zum Zitat Lee SR, Choi EK, Park CS, et al. Direct oral anticoagulants in patients with nonvalvular atrial fibrillation and low body weight. J Am Coll Cardiol. 2019;73(8):919–31.PubMedCrossRef Lee SR, Choi EK, Park CS, et al. Direct oral anticoagulants in patients with nonvalvular atrial fibrillation and low body weight. J Am Coll Cardiol. 2019;73(8):919–31.PubMedCrossRef
45.
Zurück zum Zitat Lee SR, Choi EK, Han KD, Jung JH, Oh S, Lip GYH. Edoxaban in Asian patients with atrial fibrillation: effectiveness and safety. J Am Coll Cardiol. 2018;72(8):838–53.PubMedCrossRef Lee SR, Choi EK, Han KD, Jung JH, Oh S, Lip GYH. Edoxaban in Asian patients with atrial fibrillation: effectiveness and safety. J Am Coll Cardiol. 2018;72(8):838–53.PubMedCrossRef
46.
Zurück zum Zitat Lee SR, Choi EK, Han KD, et al. Non-vitamin K antagonist oral anticoagulants in Asian patients with supranormal renal function. Stroke. 2019;50(6):1480–9.PubMedCrossRef Lee SR, Choi EK, Han KD, et al. Non-vitamin K antagonist oral anticoagulants in Asian patients with supranormal renal function. Stroke. 2019;50(6):1480–9.PubMedCrossRef
47.
Zurück zum Zitat Lee SR, Choi EK, Han KD, Jung JH, Oh S, Lip GYH. Optimal rivaroxaban dose in Asian patients with atrial fibrillation and Normal or mildly impaired renal function. Stroke. 2019;50(5):1140–8.PubMedCrossRef Lee SR, Choi EK, Han KD, Jung JH, Oh S, Lip GYH. Optimal rivaroxaban dose in Asian patients with atrial fibrillation and Normal or mildly impaired renal function. Stroke. 2019;50(5):1140–8.PubMedCrossRef
48.
Zurück zum Zitat Park J, Kwon S, Choi EK, et al. Validation of diagnostic codes of major clinical outcomes in a National Health Insurance database. Int J Arrhythm. 2019;20(5). Park J, Kwon S, Choi EK, et al. Validation of diagnostic codes of major clinical outcomes in a National Health Insurance database. Int J Arrhythm. 2019;20(5).
Metadaten
Titel
Proton Pump Inhibitor Co-Therapy in Patients with Atrial Fibrillation Treated with Oral Anticoagulants and a Prior History of Upper Gastrointestinal Tract Bleeding
verfasst von
So-Ryoung Lee
Soonil Kwon
Eue-Keun Choi
Jin-Hyung Jung
Kyung-Do Han
Seil Oh
Gregory Y. H. Lip
Publikationsdatum
17.03.2021
Verlag
Springer US
Erschienen in
Cardiovascular Drugs and Therapy / Ausgabe 4/2022
Print ISSN: 0920-3206
Elektronische ISSN: 1573-7241
DOI
https://doi.org/10.1007/s10557-021-07170-6

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