title: Evaluating the Primary Prevention of Ischemic Stroke of Oral Antithrombotic Therapy in Head and Neck Cancer Patients with Radiation Therapy.
abstract: Although previous studies demonstrated the risk of ischemic stroke (IS) in patients with head and neck cancer (HNC), the impact of oral antithrombotic therapy (OAT) on this risk has not yet been assessed. We aimed to evaluate the effectiveness and safety of OAT in patients with HNC treated with RT. This retrospective cohort study was performed using the National Health Insurance Research Database of Taiwan. A total of 37,638 patients diagnosed with HNC included in the study were classified as users and nonusers of OAT. Primary outcome was IS or transient ischemic attack (TIA), and secondary outcomes were death and major bleeding. The Cox proportional hazards model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). There was no significant difference in the risk of IS or TIA between patients on continuous OAT and nonusers (adjusted HR, 0.812; 95% CI, 0.199-3.309). The risk of major bleeding was not significantly different between the groups. From a national population database, we did not find an association between OAT and decreasing risk of ischemic stroke/TIA or increasing hazard of major bleeding.
authors.affiliation: School of Pharmacy, Master Program in Clinical Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Chin-Wei
authors.initials: CW
authors.lastname: Hsu
authors.affiliation: School of Pharmacy, Master Program in Clinical Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Yaw-Bin
authors.identifier: 0000-0002-6024-0108
authors.initials: YB
authors.lastname: Huang
authors.affiliation: Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Chen-Chun
authors.identifier: 0000-0001-5464-5056
authors.initials: CC
authors.lastname: Kuo
authors.affiliation: School of Pharmacy, Master Program in Clinical Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Chung-Yu
authors.identifier: 0000-0001-7206-3957
authors.initials: CY
authors.lastname: Chen
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000532:radiotherapy*; D006470:Hemorrhage / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention / Q000706:statistics & numerical data; D011832:Radiation Injuries / Q000453:epidemiology / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000517:prevention & control*; D013624:Taiwan / Q000453:epidemiology; D013927:Thrombosis / Q000453:epidemiology* / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents