Publications by authors named "Chuan-Tsai Tsai"
Article Synopsis
- The study investigates post-stroke antithrombotic therapy patterns in patients with atrial fibrillation and how these treatments impact outcomes after ischemic stroke.
- Among patients who were not taking anticoagulants before their stroke, many continued to forgo anticoagulation or only received antiplatelet medications, resulting in higher rates of recurrent strokes and mortality compared to those on non-vitamin K antagonist oral anticoagulants (NOACs).
- Continuing the same NOAC after a stroke was linked to better outcomes, while switching NOACs increased the risk of ischemic stroke, indicating that maintaining consistency in anticoagulant therapy may be crucial for patient safety and recovery.
Background: Gender is a well-recognized risk factor in atrial fibrillation (AF)-related ischemic stroke. The association of gender with the use of oral anticoagulants (OACs) and prognosis remains unknown.
Methods: The National Health Insurance Research Database in Taiwan identified 203,775 patients with AF aged 20 years from 2012 to 2018, with 55.
Background: In post-stroke atrial fibrillation (AF) patients who have indications for both oral anticoagulant (OAC) and antiplatelet agent (AP), e.g., those with carotid artery stenosis, there is debate over the best antithrombotic strategy.
View Article and Find Full Text PDFArticle Synopsis
- Reduced-dose apixaban is recommended for atrial fibrillation patients who meet specific criteria, but the optimal dose for Asian patients with certain kidney function levels is unclear.
- A study analyzed 13,508 patients to compare outcomes of low-dose vs. standard-dose apixaban and warfarin in those with low serum creatinine and kidney function.
- Patients taking low-dose apixaban had a significantly lower risk of mortality and major complications compared to those on warfarin, but standard-dose apixaban showed similar risks to warfarin.
Article Synopsis
- Dementia patients are more likely to develop atrial fibrillation (AF) compared to those without dementia, with the risk of incident AF being significantly higher across various dementia types.
- The study found that warfarin, a type of oral anticoagulant, increased the risk of ischemic stroke and bleeding events in dementia patients who developed AF, while non-VKA anticoagulants (NOACs) were linked to lower risks of these complications.
- The findings highlight the need for better representation of dementia patients in clinical trials and consideration of anticoagulant treatment options tailored to this population.
Insulin resistance (IR) is associated with cardiovascular disease in non-diabetic patients. The triglyceride-glucose (TyG) index, incorporating serum glucose and insulin concentrations, is a surrogate insulin resistance marker. We investigated its association with obstructive coronary artery disease (CAD) and sex differences therein.
View Article and Find Full Text PDFAsymmetric dimethylarginine (ADMA) is considered to be an atherogenic molecule. We aimed to investigate the relationship between ADMA and plaque vulnerability assessed by optical coherence tomography (OCT) in patients with stable coronary artery disease (CAD). Two hundred and forty-five patients with stable CAD undergoing OCT-guided percutaneous coronary intervention were included in this study and were divided into two groups according to their ADMA levels.
View Article and Find Full Text PDFBackground: Serum 1,5-anhydro-D-glucitol (1,5-AG) is a novel biomarker for short-term glycemic status and postprandial hyperglycemia. The association between serum 1,5-AG levels and coronary artery calcification (CAC) through a quantitative assessment using optical coherence tomography (OCT) is unclear. We aimed to evaluate this association using OCT in patients with diabetes mellitus (DM).
View Article and Find Full Text PDFObjectives: Acute infection is a well-known provocative factor of acute myocardial infarction (AMI). Prognosis is worse when it is associated with sepsis. Coronary revascularization is reported to provide benefit in these patients; however, the optimal timing remains uncertain.
View Article and Find Full Text PDFBackground: Although atrial fibrillation (AF) is a risk factor for ischemic bowel disease, data regarding the incidence of ischemic bowel disease in patients with anticoagulated AF were limited.
Methods: The present study used the Taiwan NHIRD and included newly diagnosed patients with AF aged ≥ 20 years without ischemic bowel disease from 2012 to 2018. A total of 69,549 patients taking warfarin or non-vitamin K antagonist oral anticoagulants (NOACs) constituted the final study group.
Background: The results of the recent Amsterdam Investigator-Initiated Absorb Strategy All-Comers trial showed that the predilatation, sizing, and postdilatation (PSP) technique did not lower the long-term rates of scaffold thrombosis and adverse events. We evaluated the impact of aggressive PSP bioresorbable vascular scaffold (BRS) implantation on the short- and long-term clinical outcomes.
Methods: From June 2014 to December 2016, 150 patients with BRS implantation were enrolled and received successful percutaneous coronary intervention (PCI), of whom 104 received aggressive PSP technique (high-pressure predilatation and lesion preparation in addition to the traditional PSP technique).
Aging is an important risk factor for adverse events in elderly patients with atrial fibrillation (AF) and complicates the management of anticoagulation. Underuse of oral anticoagulants (OACs) is common in elderly patients because of comorbidities, the altered physiological function of multiple organs, frailty, risk of falls, and the lack of randomized controlled trials (RCTs) specifically for elderly patients. Nevertheless, current data still support OACs use for reducing ischemic stroke with positive net clinical benefits.
View Article and Find Full Text PDFBackground: Coronary angiography (CA) or percutaneous coronary intervention (PCI) after transcatheter aortic valve replacement (TAVR) may become technically challenging after implantation of the self-expanding Medtronic CoreValve (MCV) device, which extends above the coronary ostia. The aim of this study was to investigate the incidence and feasibility of CA or PCI and the outcomes of PCI after TAVR with the MCV device.
Methods: From July 2014 to April 2020, among 209 patients treated with TAVR with a MCV device, 14 (7%) underwent CA or PCI after the procedure at a mean duration of 28 ± 15 months at our institution.
Background: Obesity is associated with metabolic syndrome which increases further risk of coronary artery disease and adverse cardiovascular events. Impact of body mass index (BMI) on long-term outcome in patients with coronary chronic total occlusion (CTO) is less clear.
Method And Results: From January 2005 to November 2020, a total of 1301 patients with coronary angiographic confirmed CTO were enrolled in our study.
Article Synopsis
- Galectin-1 (Gal-1) is a protein linked to inflammation and chronic kidney disease, but its impact on mortality and acute kidney injury (AKI) in critically ill patients is not fully understood.
- A study involving 350 ICU patients showed that higher levels of serum Gal-1 correlated with increased mortality rates and a higher likelihood of AKI within 48 hours of admission.
- The findings indicate that elevated serum Gal-1 at ICU admission is an independent predictor of both 90-day mortality and early AKI, suggesting its potential as a biomarker for patient outcomes.
Article Synopsis
- A study examined the effects of non-vitamin K oral anticoagulants (NOACs) versus warfarin in patients aged 85 and older with atrial fibrillation (AF) using Taiwan's health database.
- After matching for similar characteristics, results showed that NOACs, especially dabigatran, rivaroxaban, and apixaban, had a lower risk of intracranial hemorrhage, mortality, and major adverse events compared to warfarin.
- The findings suggest that NOACs are a safer and potentially more effective option for preventing strokes in elderly patients with AF.
Background: Diabetes mellitus is one of the risk factors for coronary artery disease and frequently associated with multivessels disease and poor clinical outcomes. Long term outcome of successful revascularization of chronic total occlusions (CTO) in diabetes patients remains controversial.
Methods And Results: From January 2005 to December 2015, 739 patients who underwent revascularization for CTO in Taipei Veterans General Hospital were included in this study, of which 313 (42%) patients were diabetes patients.
Importance: Current guidelines recommend the use of non-vitamin K antagonist oral anticoagulants (NOACs) for stroke prevention in patients with atrial fibrillation (AF). Data regarding warfarin sodium use compared with NOAC use in patients with AF with a history of intracranial hemorrhage (ICH) are limited.
Objective: To compare the clinical outcomes of warfarin use and NOAC use in patients with AF with a history of ICH using a nationwide cohort with AF.
Introduction: To evaluate efficacy of antithrombotic agents in critically ill patients with elevated troponin I level during intensive care unit (ICU) admission.
Methods And Results: It was a retrospective observational study which was conducted in a tertiary teaching hospital in Taipei, Taiwan. All patients hospitalized in ICU for >3 days and with available serum troponin I data from December 2015 to July 2017 were included.
Background: Impaired bioavailability of endothelium-derived nitric oxide (NO) and endothelial dysfunction may play a pivotal role in the pathogenesis of in-stent restenosis (ISR) after coronary stenting. We aimed to investigate the relation between asymmetric dimethylarginine (ADMA), an endogenous NO synthase inhibitor, and the ISR lesions tissue characteristics assessed by optical coherence tomography (OCT).
Methods And Results: Forty-five patients with symptomatic ISR lesions (17 bare metal stents, 28 drug-eluting stents, medium implantation duration: 58.
Background: For patients with atrial fibrillation (AF) receiving cardiac implantable electronic device (CIED) implantations, current consensus recommends uninterrupted non-vitamin K antagonist oral anticoagulant (NOAC) considering low incidence of bleeding or thrombo-embolic events. It remains unknown whether uninterrupted strategy outweighs discontinuation method for patients receiving NOAC.
Methods: From January 1, 2013 to June 1, 2017, we enrolled 100 patients (mean age 78.