Publications by authors named "Tze Fan Chao"
East Asian populations exhibit a high burden of atrial fibrillation (AF) and AF-related ischemic strokes. The countries/regions in East Asia have diversities regarding patient characteristics and varying patient care represented by different adherence rates to the ABC (Atrial Fibrillation Better Care) pathway. Two changes, "from non-anticoagulation to direct oral anticoagulants (DOACs)" and "from lower dosing to appropriate dosing DOACs", have been identified in East Asia and have been temporally linked to improved clinical outcomes in AF patients.
View Article and Find Full Text PDFRenal function, assessed by creatinine clearance (CrCl), affects the efficacy and safety of oral anticoagulant (OAC) therapy in patients with atrial fibrillation (AF). To investigate the association between CrCl and the risk of clinical adverse events and compare the safety profiles of vitamin K antagonists (VKA) and non-vitamin K antagonist oral anticoagulants (NOAC). Patients with newly diagnosed AF (< 3 months before baseline visit) were collected from the prospective Global Registry on Long-Term Oral Anti-Thrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF) registry Phase III.
View Article and Find Full Text PDFBackground: Atrial fibrillation (AF) screening identifies undiagnosed patients who can benefit from anticoagulant therapy, thereby reducing the risk of ischemic stroke. However, the long-term outcomes and costs related to population screening for this purpose in the Asian elderly remain unknown.
Objectives: This study aimed to evaluate the cost-effectiveness of population screening for AF in the elderly in Taiwan and explore the optimal screening strategy from the health care sector's perspective.
Temporal trends of prescription rates, oral anticoagulants dose, clinical outcomes and factors associated with non-anticoagulation in patients with incident atrial fibrillation.
Eur Heart J Qual Care Clin Outcomes
January 2025
Objective: To analyze the temporal trends of oral anticoagulant (OAC) prescription, direct oral anticoagulant (DOAC) dose, clinical outcomes and factors associated with non-anticoagulation in patients with incident atrial fibrillation (AF).
Patients And Methods: During January 1, 2011, to December 31, 2020, a total of 249,107 patients with newly diagnosed AF were identified, and the 1-year risks of ischemic stroke, intracranial hemorrhage (ICH), and all-cause mortality were analyzed.
Results: OAC prescription increased from 22.
Background: Polypharmacy (i.e., treatment with ≥ 5 drugs) is common in patients with atrial fibrillation (AF) and has been associated with suboptimal management and worse outcomes.
View Article and Find Full Text PDFBackground: Patients with atrial fibrillation (AF) who suffered a previous stroke are at increased risk of recurrent thromboembolic events and other major outcomes. The impact of the number of stroke episodes on the natural history of patients with AF is still unclear.
Methods And Results: Using data from the international, multicenter, and prospective GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation) Registry Phase III, we categorized patients with a recent diagnosis of non-valvular AF according to the number of previous strokes (either 0, 1, or ≥2 episodes).
Article Synopsis
- Edoxaban, a non-vitamin K oral anticoagulant, is approved for stroke prevention in atrial fibrillation (AF) patients in many Asian countries, but its long-term effectiveness and safety had limited data in Taiwan prior to this study.
- The Global ETNA-AF registry analyzed two-year outcomes in Taiwan and three other Asian countries, revealing that edoxaban users in Taiwan were generally older with lower kidney function but showed comparable low rates of clinical events across regions.
- The study concluded that despite some variations in patient characteristics, the low rates of cardiovascular death and major bleeding events indicate that edoxaban is effective and safe for routine clinical use among AF patients in Taiwan and other Asian countries.
Background: Coronary artery disease (CAD) and atrial fibrillation (AF) often coexist, but the impact of clinical phenotypes of CAD on outcomes in AF patients in the non-vitamin K antagonist oral anticoagulant drugs (NOACs) era is less well understood.
Methods: This was a post-hoc of the GLORIA-AF registry, a global, multicenter, prospective AF registry study. Patients were divided into three groups: prior history of myocardial infarction (MI)/unstable angina group (Group 1); stable angina group (Group 2); and a control group without stable angina or history of MI/unstable angina.
Background: Undetected atrial fibrillation (AF) poses a significant risk of stroke and cardiovascular mortality. However, diagnosing AF in real-time can be challenging as the arrhythmia is often not captured instantly. To address this issue, a deep-learning model was developed to diagnose AF even during periods of arrhythmia-free windows.
View Article and Find Full Text PDFBackground: Reliable diagnostic coding schemas are essential for accurately assessing bleeding risks in patients on oral anticoagulants, particularly in observational studies.
Objectives: This study evaluated how different published diagnostic coding schemas impact the assessment of major bleeding risks associated with direct oral anticoagulants (DOACs) and warfarin.
Methods: This retrospective cohort study included patients with atrial fibrillation who initiated DOACs or warfarin between 2012 and 2019 using Taiwan's national claims database.
Peripheral artery disease, antithrombotic treatment and outcomes in European and Asian patients with atrial fibrillation: analysis from two prospective observational registries.
BMC Med
December 2024
Background: In patients with atrial fibrillation (AF), the impact of peripheral artery disease (PAD) on oral anticoagulant (OAC) therapy use and the risk of outcomes remains unclear.
Objective: To analyse the epidemiology of PAD in a large cohort of European and Asian AF patients, and the impact on treatment patterns and risks of adverse outcomes.
Methods: We analysed AF patients from two large prospective observational registries.
Background: Hematuria is common in patients with atrial fibrillation (AF) on oral anticoagulants (OACs). However, risks of incident genitourinary (GU) malignancy and detailed etiologies of hematuria have not been well studied.
Objective: We aimed to investigate the risk of hematuria and underlying GU malignancy in patients with AF receiving OACs.
Background: Anticoagulation therapy in patients with atrial fibrillation (AF) and concomitant cancer can be challenging due to the significantly increased risk of both embolism and bleeding. Moreover, the benefits and risks of vitamin K antagonists (VKA, eg. warfarin) versus non-vitamin K antagonist oral anticoagulants (NOACs) in such patients are less well understood.
View Article and Find Full Text PDFArticle Synopsis
- The study explored the effects of initial serum sodium changes in type 2 diabetes patients starting SGLT2 inhibitor therapy and monitored their clinical outcomes.
- In a cohort of 4400 patients treated from 2016 to 2021, most showed minimal sodium change, but 8.6% experienced low sodium (hyponatraemia) and 3.6% high sodium (hypernatraemia).
- Hyponatraemia after starting treatment was linked to significantly higher risks of major cardiovascular events, heart failure hospitalizations, renal issues, and overall mortality.
Article Synopsis
- A study explored the risk of thromboembolic events in patients with atrial fibrillation (AF) who were on oral anticoagulants (OACs) by analyzing different patient profiles.
- Researchers used data from over 22,000 patients in the GLORIA-AF registry and identified five distinct patient profiles, including factors like age, obesity, and hypertension.
- Among the profiles, "frailty" had the highest risk for thromboembolic events and death, while a profile classified as "young and obese" showed the lowest risk, highlighting the need for tailored risk assessment in AF patients.
Aims: Atrial fibrillation (AF) and diabetes mellitus (DM) are both associated with adverse clinical events, but the associations have not been fully elucidated, particularly with concomitant insulin use. This study aimed to analyse the associations between adverse events and DM, as well as adverse events and sole insulin use.
Materials And Methods: Our analysis included individuals with AF from the prospective Global Registry on Long-Term Oral Anti-Thrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF) registry with 3-year follow-up.
The burden of cardiovascular disease in Asia from 2025 to 2050: a forecast analysis for East Asia, South Asia, South-East Asia, Central Asia, and high-income Asia Pacific regions.
Lancet Reg Health West Pac
August 2024
Article Synopsis
- A study forecasts a 91.2% increase in crude cardiovascular disease (CVD) mortality in Asia from 2025 to 2050, despite a 23.0% decrease in the age-standardized mortality rate.
- Ischaemic heart disease and stroke will remain the top causes of mortality, with Central Asia experiencing the highest mortality rates while high systolic blood pressure is identified as the leading risk factor across most of Asia.
- The research highlights the need for targeted health interventions due to the significant variations in CVD burden across different regions in Asia.
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.
Aim: To assess if early change in albuminuria was linked to an initial change in estimated glomerular filtration rate (eGFR) and long-term kidney outcomes in people with type 2 diabetes (T2D) receiving sodium-glucose cotransporter-2 (SGLT2) inhibitors.
Methods: Using a medical database from a multicentre healthcare institute in Taiwan, we retrospectively enrolled 8310 people receiving SGLT2 inhibitors from 1 June 2016 to 31 December 2021. We compared the risks of initial eGFR decline, major adverse renal events (MARE; >50% eGFR reduction or development of end-stage kidney disease), major adverse cardiovascular events (MACE), or hospitalization for heart failure (HHF) using a Cox proportional hazards model.
Article Synopsis
- LV systolic strain is a potentially better indicator of heart function compared to LV ejection fraction (LVEF) in patients with mildly reduced ejection fraction heart failure (HFmrEF).
- A study involving 1,075 hospitalized HFmrEF patients demonstrated that LV strain is significantly associated with cardiac risk and clinical outcomes, outperforming LVEF in survival predictions.
- The research suggests that lower LV strain levels can more effectively indicate the benefits of angiotensin receptor-neprilysin inhibitor (ARNi) treatments compared to traditional LVEF, making it a valuable tool for risk assessment and therapy responsiveness in these patients.
Article Synopsis
- * Data from over 14,000 AF patients were analyzed, revealing that after three years, there were significant rates of major cardiovascular events (MACE) and death among those on different treatment regimens.
- * Results showed that patients using combination therapy (beta-blockers and digoxin) had a higher risk of MACE and all-cause death compared to those using only beta-blockers.
Background: The aim of this study was to evaluate the impact of educational status (ES) on the clinical course of Asian patients with atrial fibrillation (AF).
Methods: We used data from the prospective APHRS-AF Registry. ES was classified as follows: low (primary school), medium (secondary), and high (University).
Article Synopsis
- Signal-averaged electrocardiography (SAECG) was studied in patients with nonischemic cardiomyopathies (NICMs) to determine its diagnostic and prognostic value regarding ventricular arrhythmia (VA).
- In a study of 58 NICM patients, those who met at least one SAECG criterion showed larger areas of scar tissue and more frequently had extremely low-voltage zones than those who did not meet the criteria.
- The findings suggest that a positive SAECG indicates a greater risk for arrhythmogenic issues in NICM patients, although it did not significantly correlate with long-term recurrence of ventricular arrhythmias.