Effectiveness and Safety of Direct Oral Anticoagulants in Thai Patients with Atrial Fibrillation: A Real-World Retrospective Cohort Study.

Background: Direct oral anticoagulants (DOACs) are commonly used to prevent stroke and systemic embolism in patients with atrial fibrillation (AF). However, studies into their effectiveness and safety in the Thai population have so far been limited.

Objectives: To study the effectiveness and safety of warfarin and DOACs among Thai AF patients.

Real-World Comparative Effectiveness and Safety of Non-Vitamin K Antagonist Oral Anticoagulants vs. Warfarin in a Developing Country.

We aimed to compare effectiveness and safety of the non-vitamin K antagonist oral anticoagulants (NOACs) vs. warfarin for stroke prevention in nonvalvular atrial fibrillation (NVAF) in a developing country where anticoagulation control with warfarin is suboptimal. A real-world study was conducted among patients with NVAF in Thailand receiving NOACs and warfarin from 9 hospitals during January 2012 to April 2018.

Clinical Predictors Influencing the Length of Stay in Emergency Department Patients Presenting with Acute Heart Failure.

Acute heart failure is a common problem encountered in the emergency department (ED). More than 80% of the patients with the condition subsequently require lengthy and repeated hospitalization. In a setting with limited in-patient capacity, the patient flow is often obstructed.

Prescriber compliance to direct oral anticoagulant labels and impact on outcomes in Thailand.

Aims: This study aimed to evaluate the prescriber compliance to the approved labels of direct oral anticoagulants (DOACs) and impact of appropriateness of dosing on clinical outcomes.

Methods: A retrospective study was conducted using simple-stratified random sampling of adult patients receiving ≥6 months of DOACs for various indications during 2013-2017 in 10 tertiary care hospitals. Patients were classified into 3 dosing groups including approved dose, underdosing and overdosing based on the Thai Food and Drug Administration-approved labels.

Use of the CRUSADE bleeding risk score in the prediction of major bleeding for patients with acute coronary syndrome receiving enoxaparin in Thailand.

Background: CRUSADE risk score stands out as a simple-to-use bleeding risk model. However, its use is still doubtful for Thai population. The aim of this study was to assess the prognostic value of CRUSADE in predicting risk of major bleeding among Thai patients with acute coronary syndrome (ACS) receiving enoxaparin.

Fragmented QRS as a Predictor of Appropriate Implantable Cardioverter-defibrillator Therapy.

Background: Fragmented QRS (fQRS) has been shown to be a marker of local myocardial conduction abnormalities and a predictor of cardiac events in selected populations. We hypothesized that the presence of a fQRS might predict arrhythmic events in patients who received an implantable cardioverter-defibrillator (ICD), regardless of the indications for implantation.

Methods And Results: A cohort of 107 consecutive patients (mean age, 53 years; 82% male) who underwent an ICD implantation was studied.

Attributable Cost and Length of Stay for Patients with Enoxaparin-Associated Bleeding.

Objectives: Patients receiving enoxaparin are at risk of bleeding. The study of the economic impact of enoxaparin-associated bleeding in Asian population, however, is limited. This study aimed to estimate the attributable costs and length of stay (LOS) of patients experiencing enoxaparin-associated bleeding compared with nonbleeding patients in the setting of acute coronary syndrome.

Association between cigarette smoking and the intraoral distribution of periodontal disease in Thai men over 50 years of age.

Aim: This study aimed to investigate the effects of cigarette smoking on periodontal conditions in specific tooth regions of older Thai men.

Methods: There were 272 current smokers, 714 former smokers, and 477 non-smokers enrolled in the present study. Differences between groups in the mean probing depth or attachment loss were compared using ancova.

Aggregatibacter actinomycetemcomitans serotypes, the JP2 clone and cytolethal distending toxin genes in a Thai population.

Aim: To examine the genetic diversity of Aggregatibacter actinomycetemcomitans in Thai adults.

Materials And Methods: Subgingival plaque samples from 453 subjects were analysed for A. actinomycetemcomitans serotypes, the presence of the high leukotoxin-producing JP2 clone and cytolethal distending toxin genes (cdtABC) using the polymerase chain reaction technique.

Lipid-lowering treatment in hypercholesterolemic patients: the CEPHEUS Thailand survey.

Background: Atherosclerotic cardiovascular disease (ASCVD) has become the leading cause of death and disability in Thailand. Low-density lipoprotein cholesterol is the major risk factor of this condition that can be intervened by means of lifestyle modification and pharmacologic treatment. Adequacy of hypercholesterolemia treatment with lipid lowering drugs in Thailand needed to be more clarified.

Prevention of ventricular fibrillation episodes in Brugada syndrome by catheter ablation over the anterior right ventricular outflow tract epicardium.

Background: The underlying electrophysiological mechanism that causes an abnormal ECG pattern and ventricular tachycardia/ventricular fibrillation (Vt/VF) in patients with the Brugada syndrome (BrS) remains unelucidated. However, several studies have indicated that the right ventricular outflow tract (RVOT) is likely to be the site of electrophysiological substrate. We hypothesized that in patients with BrS who have frequent recurrent VF episodes, the substrate site is the RVOT, either over the epicardium or endocardium; abnormal electrograms would be identified at this location, which would serve as the target site for catheter ablation.

Feasibility, efficacy, and safety of radiofrequency catheter ablation for cardiac arrhythmias: a twelve-year experience in Thailand.

Background: Radiofrequency catheter ablation (RFCA) is widely accepted as a curative treatment for many types of cardiac arrhythmias.

Material And Method: The authors retrospectively reviewed 1,193 cases (mean age 45, 41% male) performed in the electrophysiology laboratory at Ramathibodi Hospital from 1996 to 2007. Success rate, recurrence rate and complications were analyzed.

Relationship between the presence of certain bacterial pathogens and periodontal status of urban Thai adults.

Background: The association between Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis, and Tannerella forsythia (previously T. forsythensis) and periodontal disease has been reported in Western populations. However, corresponding data in Asian populations are still lacking.

Chryseobacterium meningosepticum infection and cardiac tamponade in a long-term hemodialysis patient.

Chryseobacterium meningosepticum is a lactose-nonfermenting gram-negative bacilli ubiquitously found in the natural and hospital environment. Clinical infection caused by C. meningosepticum is very rare among healthy adults.

Correction of hypercoagulability and amelioration of pulmonary arterial hypertension by chronic blood transfusion in an asplenic hemoglobin E/beta-thalassemia patient.

Chronic transfusion of packed red blood cells, in addition to other ongoing treatment with warfarin, acetyl salicylic acid, desferrioxamine, and other supportive measures, was given to a splenectomized hemoglobin E/beta-thalassemia woman with pulmonary arterial hypertension (PHT). Serial measurements of plasma thrombin-antithrombin III complex (TAT) levels and right-sided cardiac catheterization were used to monitor changes after treatment. Reduction of plasma TAT levels from 7.

Pulmonary arterial hypertension in previously splenectomized patients with beta-thalassemic disorders.

Our aim was to study the cause and describe the clinical features of pulmonary arterial hypertension (PHT) in splenectomized beta-thalassemia (beta-Thal) patients. Ten splenectomized beta-Thal patients with systolic pulmonary artery (PA) pressure >30 mm Hg were evaluated by echocardiography, right-heart catheterization, and pulmonary angiography. Five of these patients later underwent hemodynamic studies.

Defibrillator Versus beta-Blockers for Unexplained Death in Thailand (DEBUT): a randomized clinical trial.

Background: Sudden Unexplained Death Syndrome (SUDS) is the leading cause of death in young, healthy, Southeast Asian men. The role of an implantable cardioverter defibrillator (ICD) for mortality reduction in these patients remains unclear.

Methods And Results: The Defibrillator Versus beta-Blockers for Unexplained Death in Thailand (DEBUT) study is a randomized, clinical trial conducted in 2 phases (pilot study followed by the main trial) to compare the annual all-cause mortality rates among SUDS patients treated with beta-blockers versus that among those treated with an ICD.