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Incidence of major bleeding among oral anticoagulants / Ziran Nadiah Ghazali

Oral anticoagulant is widely used in Malaysia to prevent thromboembolic events. Commonly used oral anticoagulants in Hospital Putrajaya are Warfarin, Rivaroxaban and Dabigatran. In patient with atrial fibrillation, the risk of stroke increases to 5-fold in patients and use of anticoagulant therapy r...

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Main Author: Ghazali, Ziran Nadiah
Format: Thesis
Language:English
Published: 2017
Subjects:
Oral and dental medicine. Pathology. Diseases
Online Access:http://ir.uitm.edu.my/id/eprint/26269/1/TM_ZIRAN%20NADIAH%20GHAZALI%20PH%2017_5.pdf
http://ir.uitm.edu.my/id/eprint/26269/
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spelling my.uitm.ir.262692019-10-23T06:28:06Z http://ir.uitm.edu.my/id/eprint/26269/ Incidence of major bleeding among oral anticoagulants / Ziran Nadiah Ghazali Ghazali, Ziran Nadiah Oral and dental medicine. Pathology. Diseases Oral anticoagulant is widely used in Malaysia to prevent thromboembolic events. Commonly used oral anticoagulants in Hospital Putrajaya are Warfarin, Rivaroxaban and Dabigatran. In patient with atrial fibrillation, the risk of stroke increases to 5-fold in patients and use of anticoagulant therapy reduces the risk of stroke and all-cause mortality. Although proven to be effective, these oral anticoagulants can cause major bleeding. This study was carried out retrospectively in adult patients from INR Clinic with oral anticoagulant. The assessment parameter was incidence of major bleeding event. Among 113 enrolled patients, 19 had a first major bleeding event. It was found that age (OR 1.06; 95% CI 1.02, 1.11) and overwarfarinisation event (OR 1.91; 95% CI 1.26, 2.89) is significant to increase patient’s risk to major bleeding. Comorbid of hypertension (OR 2.66; 95% CI 0.82, 8.63), congestive heart failure (OR 2.44; 95% CI 0.74, 8.00, renal impairment specifically stage 4 (OR 9.00; 95% CI 0.72, 113.02) and stage 5 (OR 6.00; 95% CI 0.42, 85.25), concomitant antiplatelet therapy (OR 0.43; 95% CI 0.13, 1.40), types of oral anticoagulant (novel anticoagulant vs warfarin) (OR 3.42; 95% CI 0.42, 27.58) and TTR (OR 0.96; 95% CI 0.93, 1.00) and other factors studied are not significant in this study. High risk patient should be identified based on the factors exist in them and monitored frequently to minimize the adverse effect of anticoagulant. Patient with first event of major bleeding and especially elderly should be monitored more stringently as they may develop subsequent fatal bleed. Keywords: oral anticoagulant, warfarin, dabigatran, rivaroxaban, major bleeding, bleeding 2017 Thesis NonPeerReviewed text en http://ir.uitm.edu.my/id/eprint/26269/1/TM_ZIRAN%20NADIAH%20GHAZALI%20PH%2017_5.pdf Ghazali, Ziran Nadiah (2017) Incidence of major bleeding among oral anticoagulants / Ziran Nadiah Ghazali. Masters thesis, Universiti Teknologi MARA.
institution Universiti Teknologi Mara
building Tun Abdul Razak Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Teknologi Mara
content_source UiTM Institutional Repository
url_provider http://ir.uitm.edu.my/
language English
topic Oral and dental medicine. Pathology. Diseases
spellingShingle Oral and dental medicine. Pathology. Diseases
Ghazali, Ziran Nadiah
Incidence of major bleeding among oral anticoagulants / Ziran Nadiah Ghazali
description Oral anticoagulant is widely used in Malaysia to prevent thromboembolic events. Commonly used oral anticoagulants in Hospital Putrajaya are Warfarin, Rivaroxaban and Dabigatran. In patient with atrial fibrillation, the risk of stroke increases to 5-fold in patients and use of anticoagulant therapy reduces the risk of stroke and all-cause mortality. Although proven to be effective, these oral anticoagulants can cause major bleeding. This study was carried out retrospectively in adult patients from INR Clinic with oral anticoagulant. The assessment parameter was incidence of major bleeding event. Among 113 enrolled patients, 19 had a first major bleeding event. It was found that age (OR 1.06; 95% CI 1.02, 1.11) and overwarfarinisation event (OR 1.91; 95% CI 1.26, 2.89) is significant to increase patient’s risk to major bleeding. Comorbid of hypertension (OR 2.66; 95% CI 0.82, 8.63), congestive heart failure (OR 2.44; 95% CI 0.74, 8.00, renal impairment specifically stage 4 (OR 9.00; 95% CI 0.72, 113.02) and stage 5 (OR 6.00; 95% CI 0.42, 85.25), concomitant antiplatelet therapy (OR 0.43; 95% CI 0.13, 1.40), types of oral anticoagulant (novel anticoagulant vs warfarin) (OR 3.42; 95% CI 0.42, 27.58) and TTR (OR 0.96; 95% CI 0.93, 1.00) and other factors studied are not significant in this study. High risk patient should be identified based on the factors exist in them and monitored frequently to minimize the adverse effect of anticoagulant. Patient with first event of major bleeding and especially elderly should be monitored more stringently as they may develop subsequent fatal bleed. Keywords: oral anticoagulant, warfarin, dabigatran, rivaroxaban, major bleeding, bleeding
format Thesis
author Ghazali, Ziran Nadiah
author_facet Ghazali, Ziran Nadiah
author_sort Ghazali, Ziran Nadiah
title Incidence of major bleeding among oral anticoagulants / Ziran Nadiah Ghazali
title_short Incidence of major bleeding among oral anticoagulants / Ziran Nadiah Ghazali
title_full Incidence of major bleeding among oral anticoagulants / Ziran Nadiah Ghazali
title_fullStr Incidence of major bleeding among oral anticoagulants / Ziran Nadiah Ghazali
title_full_unstemmed Incidence of major bleeding among oral anticoagulants / Ziran Nadiah Ghazali
title_sort incidence of major bleeding among oral anticoagulants / ziran nadiah ghazali
publishDate 2017
url http://ir.uitm.edu.my/id/eprint/26269/1/TM_ZIRAN%20NADIAH%20GHAZALI%20PH%2017_5.pdf
http://ir.uitm.edu.my/id/eprint/26269/
_version_ 1685650115664019456
score 13.211869

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