Damsgaardbramsen2001

Atrial fibrillation (AF)-related stroke accounts for 20% of ischemic strokes. Rivaroxaban use in AF patients for preventing stroke and systemic embolism was approved in 2013 in Korea. This study was to investigate the safety and effectiveness of rivaroxaban use in Korean patients with non-valvular AF in a real-world setting.

This was an analysis of the Korean patients in XANAP, which was a prospective, observational cohort study including patients with non-valvular AF starting rivaroxaban treatment to prevent stroke or non-central nervous system systemic embolism (non-CNS SE), conducted in 10 Asian countries.

A total of 844 patients were enrolled in the Korean portion of the XANAP study. In XANAP Korea, the mean age was 70.1 years and 62.6% were males. The mean CHADS2 score was 2.5 and the mean CHA2DS2-VASc score was 3.8. 47% of the patients had experienced prior stroke or non-CNS SE or TIA. 73.6% of the patients had CHADS2 score ≥ 2. Incidence proportions of 0.8% of the patients (1.1 per 100-patient years) developed adjudicated treatment-emergent major bleeding. Death was observed in 1.2% of the patients. The incidence of non-major bleeding as well as thromboembolic event were 8.4% (11.6 per 100-patient years) and 1.5% (2.0 per 100-patient years), respectively.

This study reaffirmed the consistent safety profile of rivaroxaban. We found consistent results with overall XANAP population for rivaroxaban in terms of safety in NVAF patients for the prevention of stroke and non-CNS SE.

This study reaffirmed the consistent safety profile of rivaroxaban. We found consistent results with overall XANAP population for rivaroxaban in terms of safety in NVAF patients for the prevention of stroke and non-CNS SE.

Prolonged dual antiplatelet therapy (DAPT) with aspirin and clopidogrel beyond 1 year has shown to reduce ischemic events at the expense of increased bleeding; however, limited data are available on the clinical significance of platelet reactivity (PR) at 1 year in this setting.

We retrospectively identified 331 patients who underwent percutaneous coronary intervention and assessed the on-clopidogrel PR using VerifyNow P2Y12 Assay at 1 year in a single center. At the clinician's discretion, 211 patients were on DAPT for >1 year. The relationship between high on-treatment platelet reactivity (HPR) at 1 year and clinical outcomes beyond 1 year and, the longitudinal change of PR was analyzed.

At 1 year, 135 (64%) patients showed HPR, and 76 (36%) did not. There was a significant increase in ischemic endpoint events which include cardiovascular death, non-fatal myocardial infarction, stroke/transient ischemic attack in patients with than without HPR at 1 year (hazard ratio[HR], 2.68, 95% confidence interval[CI], 1.06-6.77, p=0.036). However, the incidence of any Bleeding Academic Research Consortium (BARC) bleeding was significantly low in the HPR group (HR, 0.11, 95% CI, 0.02-0.65, p=0.015). In longitudinal analysis, PR significantly decreased from post-load to 1 year after index PCI in the non-HPR group. Conversely, the HPR group showed high PR from baseline through 1 year.

HPR at 1 year may be a useful surrogate for predicting ischemic and bleeding events in patients on prolonged DAPT. Patients with and without HPR at 1 year showed different patterns of longitudinal change in PR.

HPR at 1 year may be a useful surrogate for predicting ischemic and bleeding events in patients on prolonged DAPT. Patients with and without HPR at 1 year showed different patterns of longitudinal change in PR.The Republic of Korea (ROK) experienced a public health crisis due to the Middle East respiratory syndrome (MERS) in 2015 and is currently going through the coronavirus disease 2019 (COVID-19) pandemic. Lessons learned from the disastrous MERS outbreak were reflected in the preparedness system, and readiness made since then enabled the country to successfully flatten the epidemic curve of COVID-19 in late February and March 2020. In this review, we aimed to summarize and compare the epidemiology and response of ROK to the 2015 MERS outbreak and the COVID-19 epidemic in early 2020. We emphasize that given the next waves seem inevitable, it is urgent to develop comprehensive preparedness and response plans against the worst scenarios of COVID-19 pandemic. Simultaneously strengthening healthcare capacity to endure the peak demand and smart strategies to sustain social distancing and public hygiene are necessary until the effective and safe therapeutics and vaccines against COVID-19 are available.

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.

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.

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.

The present study demonstrated no evidence of association between RAAS inhibitor exposure and risk and severity of COVID-19.

The present study demonstrated no evidence of association between RAAS inhibitor exposure and risk and severity of COVID-19.

Adjuvant chemotherapy is the standard of care for resected stage II-IIIA non-small cell lung cancer (NCSLC). The efficacy of adjuvant chemotherapy in stage IB (<4cm) NSCLC with high-risk factors remains controversial.

This was a retrospective multi-center study of four academic hospitals. We analyzed 285 stage IB NSCLC patients with high-risk factors according to the 8th edition TNM classification. High-risk factors were visceral pleural invasion, vascular invasion, lymphatic invasion, lung neuroendocrine tumors, and micropapillary histology pattern.

Of the 285 cases, 127 (44.6%) were in the adjuvant chemotherapy group and 158 (55.4%) were in the non-adjuvant chemotherapy group. NSC 178886 Median follow-up was 41.5 months. Adjuvant chemotherapy significantly reduced the recurrence rate compared to the control group (Hazards ratio, 0.408; 95% Confidence interval, 0.221-0.754; P = 0.004) and the risk of death compared to the control group (Hazards ratio, 0.176; 95% Confidence interval, 0.057-0.546; P = 0.003). Among the various high-risk factors, adjuvant chemotherapy should be more considered if there were visceral pleural involvement or vascular invasion.