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Concurrent use of Chinese herbal medicine and anticoagulants may reduce major bleeding events

BACKGROUND: This retrospective cohort study investigated the risk of major bleeding events during the concurrent use of Chinese herbal medicine (CHM) and anticoagulants in clinical practice. METHODS: A total of 4,470 patients receiving anticoagulant drugs were selected from Taiwan’s National Health...

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Autores principales: Hsu, Shuo-Min, Lin, Hung-Jen, Kao, Yi-Wei, Li, Te-Mao, Shia, Ben-Chang, Huang, Sheng-Teng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9398017/
https://www.ncbi.nlm.nih.gov/pubmed/35998204
http://dx.doi.org/10.1371/journal.pone.0271965
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author Hsu, Shuo-Min
Lin, Hung-Jen
Kao, Yi-Wei
Li, Te-Mao
Shia, Ben-Chang
Huang, Sheng-Teng
author_facet Hsu, Shuo-Min
Lin, Hung-Jen
Kao, Yi-Wei
Li, Te-Mao
Shia, Ben-Chang
Huang, Sheng-Teng
author_sort Hsu, Shuo-Min
collection PubMed
description BACKGROUND: This retrospective cohort study investigated the risk of major bleeding events during the concurrent use of Chinese herbal medicine (CHM) and anticoagulants in clinical practice. METHODS: A total of 4,470 patients receiving anticoagulant drugs were selected from Taiwan’s National Health Insurance Research Database (NHIRD). Half (n = 2,235) were also using CHMs (CHM cohort); the other half were not (non-CHM cohort). Each cohort was matched 1:1 using the propensity score. Chi-square testing and the Student’s t-test were used to examine differences between two cohorts. Cox proportional hazard regression analysis assessed the risks for major bleeding events in each cohort, as well as bleeding risks associated with specific CHM formulas and herbs. Cumulative incidence curves for major bleeding events were calculated using Kaplan-Meier analysis. RESULTS: Compared with the non-CHM cohort, the CHM cohort had a lower risk of overall bleeding events (p < 0.001) including hemorrhagic stroke (p = 0.008), gastrointestinal (GI) bleeding (p < 0.001), urogenital bleeding (p ≤ 0.001) and nasal/ear/eye bleeding (p = 0.004). Single herbs, such as Glycyrrhiza uralensis et Rhizoma, Panax notoginseng, Panax ginseng, Platycodon grandiflorum, Eucommia ulmoides Oliver and formulas, such as Shu Jing Huo Xue Tang, Shao Yao Gan Cao Tang and Ji Sheng Shen Qi Wan were associated with a lower risk of major bleeding events. CONCLUSION: Using CHMs with anticoagulants appeared to decrease the risk of major bleeding, especially CHMs products containing Glycyrrhiza uralensis et Rhizoma, Panax notoginseng, Panax ginseng, Platycodon grandiflorum and Eucommia ulmoides Oliver. Further investigations are needed to determine whether CHM can maintain the therapeutic efficacy of anticoagulants while simultaneously reducing potential side effects.
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spelling pubmed-93980172022-08-24 Concurrent use of Chinese herbal medicine and anticoagulants may reduce major bleeding events Hsu, Shuo-Min Lin, Hung-Jen Kao, Yi-Wei Li, Te-Mao Shia, Ben-Chang Huang, Sheng-Teng PLoS One Research Article BACKGROUND: This retrospective cohort study investigated the risk of major bleeding events during the concurrent use of Chinese herbal medicine (CHM) and anticoagulants in clinical practice. METHODS: A total of 4,470 patients receiving anticoagulant drugs were selected from Taiwan’s National Health Insurance Research Database (NHIRD). Half (n = 2,235) were also using CHMs (CHM cohort); the other half were not (non-CHM cohort). Each cohort was matched 1:1 using the propensity score. Chi-square testing and the Student’s t-test were used to examine differences between two cohorts. Cox proportional hazard regression analysis assessed the risks for major bleeding events in each cohort, as well as bleeding risks associated with specific CHM formulas and herbs. Cumulative incidence curves for major bleeding events were calculated using Kaplan-Meier analysis. RESULTS: Compared with the non-CHM cohort, the CHM cohort had a lower risk of overall bleeding events (p < 0.001) including hemorrhagic stroke (p = 0.008), gastrointestinal (GI) bleeding (p < 0.001), urogenital bleeding (p ≤ 0.001) and nasal/ear/eye bleeding (p = 0.004). Single herbs, such as Glycyrrhiza uralensis et Rhizoma, Panax notoginseng, Panax ginseng, Platycodon grandiflorum, Eucommia ulmoides Oliver and formulas, such as Shu Jing Huo Xue Tang, Shao Yao Gan Cao Tang and Ji Sheng Shen Qi Wan were associated with a lower risk of major bleeding events. CONCLUSION: Using CHMs with anticoagulants appeared to decrease the risk of major bleeding, especially CHMs products containing Glycyrrhiza uralensis et Rhizoma, Panax notoginseng, Panax ginseng, Platycodon grandiflorum and Eucommia ulmoides Oliver. Further investigations are needed to determine whether CHM can maintain the therapeutic efficacy of anticoagulants while simultaneously reducing potential side effects. Public Library of Science 2022-08-23 /pmc/articles/PMC9398017/ /pubmed/35998204 http://dx.doi.org/10.1371/journal.pone.0271965 Text en © 2022 Hsu et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Hsu, Shuo-Min
Lin, Hung-Jen
Kao, Yi-Wei
Li, Te-Mao
Shia, Ben-Chang
Huang, Sheng-Teng
Concurrent use of Chinese herbal medicine and anticoagulants may reduce major bleeding events
title Concurrent use of Chinese herbal medicine and anticoagulants may reduce major bleeding events
title_full Concurrent use of Chinese herbal medicine and anticoagulants may reduce major bleeding events
title_fullStr Concurrent use of Chinese herbal medicine and anticoagulants may reduce major bleeding events
title_full_unstemmed Concurrent use of Chinese herbal medicine and anticoagulants may reduce major bleeding events
title_short Concurrent use of Chinese herbal medicine and anticoagulants may reduce major bleeding events
title_sort concurrent use of chinese herbal medicine and anticoagulants may reduce major bleeding events
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9398017/
https://www.ncbi.nlm.nih.gov/pubmed/35998204
http://dx.doi.org/10.1371/journal.pone.0271965
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