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:	https://ir.uitm.edu.my/id/eprint/26269/1/TM_ZIRAN%20NADIAH%20GHAZALI%20PH%2017_5.pdf
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spelling	my-uitm-ir.262692019-10-23T06:28:06Z Incidence of major bleeding among oral anticoagulants / Ziran Nadiah Ghazali 2017 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 https://ir.uitm.edu.my/id/eprint/26269/ https://ir.uitm.edu.my/id/eprint/26269/1/TM_ZIRAN%20NADIAH%20GHAZALI%20PH%2017_5.pdf text en public masters Universiti Teknologi MARA Faculty of Pharmacy
institution	Universiti Teknologi MARA
collection	UiTM Institutional Repository
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
qualification_level	Master's degree
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
granting_institution	Universiti Teknologi MARA
granting_department	Faculty of Pharmacy
publishDate	2017
url	https://ir.uitm.edu.my/id/eprint/26269/1/TM_ZIRAN%20NADIAH%20GHAZALI%20PH%2017_5.pdf
_version_	1783733890903441408

Incidence of major bleeding among oral anticoagulants / Ziran Nadiah Ghazali

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