MyMedR

Displaying all 7 publications

Abstract:

Sort:

Fulltext Common Pregnancy Symptoms Increase the Risk Of Cardiovascular Disease

Zulkifly H, Dingle K, Clavarino A

Value Health, 2014 Nov;17(7):A554-5.
PMID: 27201816 DOI: 10.1016/j.jval.2014.08.1819
Assessing Retrospective Data on the Management of Ischemic Stroke

Zulkifly H, Othman PN, Shaharuddin S, Long CM

Value Health, 2015 Nov;18(7):A381.
PMID: 26532154 DOI: 10.1016/j.jval.2015.09.810
Fulltext Be Cautious Of Triple Whammy!!!

Zulkifly H, Abdul WM, Shaharuddin S, Chiau ML, Mat ZH

Value Health, 2014 Nov;17(7):A467.
PMID: 27201328 DOI: 10.1016/j.jval.2014.08.1312
Fulltext Relation of the time in therapeutic range (TTR) of warfarin to bleeding incidences in patients with atrial fibrillation [Abstract]

Jasmi MA, Mazlan MN, Shaharuddin S, Zulkifly HH, Long CM, Hashim R, et al.

Value Health, 2014 Nov;17(7):A478.
PMID: 27201388 DOI: 10.1016/j.jval.2014.08.1375

Conference abstract;
Objectives: Warfarin use in atrial fibrillation has been established for preventing occurrence of stroke in patients with atrial fibrillation. However, safety and clinical monitoring of warfarin use is crucial due to its risk of bleeding complications. This study aims to compare and establish relation of time in therapeutic range (TTR) of warfarin in patients with atrial fibrillation in the first 6 months and 6 month thereafter of anticoagulation therapy.
Methods: This is a retrospective study carried out at a tertiary-care hospital with anticoagulation clinic in the state of Selangor, Malaysia. Data collected included patients’ demographics, co-morbidities, and international normalized ratio (INR). TTR were determined using Rosendaal method based on records found in database (INR Desk 4.0 system) and patients’ hemorrhage events were also recorded. Samples of the study were patient who started warfarin from January 2009 until March 2013.
Results: A total of 167 patients with atrial fibrillation were enrolled and only 6% (n=10) achieved TTR of more than 75% for the first 6 months of warfarin use as compared to 16.8% (n=28) of TTR more than 75% 6 months thereafter. As for bleeding incidences, 29% (n=45) of patients in the group of TTR less than 75% in the first 6 months had bleeding complications as compared to 18.7% (n=26) in patients of TTR less than 75% 6 months after.
Conclusions: A more regular follow up is necessary during the first 6 months of new warfarin users as they tend to be out of the TTR and have a higher bleeding risk.
Study site: anticoagulation clinic, tertiary hospital, Selangor, Malaysia
Preliminary study of safety and efficacy of warfarin versus dabigatran in atrial fibrillation patients in a tertiary hospital in Malaysia [Abstract]

Mohd Hajiri M, Shaharuddin S, Long CM, Hashim R, Zulkifly HH, Kasim SS, et al.

Value Health, 2015 Nov;18(7):A378.
PMID: 26532133 DOI: 10.1016/j.jval.2015.09.795

Conference abstract:
Objectives: Warfarin has been used for more than 50 years as stroke prophylaxis in patients with atrial fibrillation. New oral anticoagulant, Dabigatran, was developed and shown to be safer and more efficacious compared to Warfarin due to its lower tendency of bleeding and in reducing stroke incidences. This study aims to compare the pattern of anticoagulants used and to assess their safety and efficacy by evaluating bleeding and stroke occurrences in both groups.
Methods: This is a retrospective study carried out at a hospital with hematology clinic in the state of Selangor, Malaysia. The samples of the study were patients with atrial fibrillation, prescribed with warfarin or dabigatran. Data collected includes patients’ demographics, co-morbidities, and stroke and haemorrhage events.
Results: A total of 71 patients were recruited in this study with 21, 21 and 29 patients were on Warfarin, Dabigatran 110 mg and Dabigatran 150 mg respectively. Out of 50 Dabigatran users, 36 of them are warfarin-experienced. 1 out of 21 patients on warfarin experienced stroke while none in both 110 and 150mg dabigatran group. A total of 11 (52.4%) of warfarin patients experienced bleeding with 2 of them having major bleeding whereas, only 4 (8%) out of 50 dabigatran patients experienced minor bleeding, 1 in patient who were on Dabigatran 150mg and 3 patients who were on Dabigatran 110mg.
Conclusions: The pattern of anticoagulant used for stroke prophylaxis in atrial fibrillation is slowly changing from Warfarin to Dabigatran. Evaluation of safety and efficacy profile of Warfarin shows that Warfarin requires more extensive management and monitoring in order to achieve therapeutic goals with fewer side effects. Comparison between both anticoagulants show that Dabigatran is safer and more effective compared to warfarin
Study site: Haematology clinic, hospital, Selangor, Malaysia
Relationship of Time in Therapeutic Range (Ttr) with Bleeding and Stroke Incidences of Warfarinised Patients with Pulmonary Embolism in a Tertiary Hospital in Malaysia

Sudirman N, Shaharuddin S, Long CM, Hashim R, Zulkifly HH, Kasim SS, et al.

Value Health, 2015 Nov;18(7):A378.
PMID: 26532135 DOI: 10.1016/j.jval.2015.09.794
Anticoagulation control in different ethnic groups receiving vitamin K antagonist therapy for stroke prevention in atrial fibrillation

Zulkifly H, Cheli P, Lutchman I, Bai Y, Lip GYH, Lane DA

Thromb Res, 2020 08;192:12-20.
PMID: 32416364 DOI: 10.1016/j.thromres.2020.04.001

BACKGROUND: Efficacy and safety of vitamin K antagonists (VKAs) is optimised in atrial fibrillation (AF) patients when the International Normalised Ratio (INR) is 2.0-3.0. Anticoagulation control comparing different ethnic groups is limited, although epidemiological studies suggest poorer INR control in non-white cohorts.
METHODS: VKA control was assessed retrospectively by time-in-the-therapeutic range (TTR) (Rosendaal method) and percentage INR-in-range (PINRR) in 991 White, Afro-Caribbean and South-Asian AF patients [overall mean (SD) age 71.6 (9.4) years; 55% male; mean (SD) CHA2DS2-VASc score 3.4 (1.6)] over a median (IQR) follow-up of 5.2 (3.2-7.0) years.
RESULTS: Compared to Whites, mean (SD) TTR and PINRR were significantly lower in South-Asians [TTR 67.9% vs. 60.5%; PINRR 58.8% vs. 51.6%, respectively] and Afro-Caribbeans [TTR 67.9% vs. 61.3%; PINRR 58.8% vs. 53.1%, respectively], despite similar INR monitoring intensity. Logistic regression revealed non-white ethnicity [OR 2.62; 95% Confidence Interval [CI] (1.67-4.10) and OR 3.47 (1.44-8.34)] and anaemia [OR 1.65 (1.00-2.70) and OR 6.27 (1.89-20.94)] as independent predictors of both TTR and PINRR