1.Increasing Very Low-Dose Edoxaban Prescription: Effectiveness and Safety Data of Korean AF Patients
JungMin CHOI ; So-Young YANG ; So-Ryoung LEE ; Min Soo CHO ; Kyung-Yeon LEE ; Hyo-Jeong AHN ; Soonil KWON ; Myung-Jin CHA ; Jun KIM ; Gi-Byoung NAM ; Kee-Joon CHOI ; Eue-Keun CHOI ; Seil OH ; Gregory Y. H. LIP
Korean Circulation Journal 2025;55(3):215-227
Background and Objectives:
Evidence remains limited on the real-world prescription of very low-dose oral anticoagulation among frail patients with atrial fibrillation (AF). We described the practice patterns, effectiveness, and safety of very low-dose edoxaban (15 mg once daily).
Methods:
Patients with AF prescribed edoxaban 15 mg once daily in 2 tertiary hospitals between 2016 and September 2022 were included. Baseline clinical characteristics and clinical outcomes of interest were thromboembolic and bleeding events.
Results:
A total of 674 patients were included (mean age 78.3±9.1, 49.7% aged ≥80 years, 49.3% women, median follow-up 1.0±1.2 years). Mean CHA 2 DS 2 -VASc score was 3.9±1.6, and the modified HAS-BLED score was 2.0±1.1. Between 2016 and 2022, the number of very lowdose edoxaban prescriptions increased. The main reasons for the prescription of very lowdose were low body weight (55.5% below 60 kg), anaemia (62.8%), chronic kidney disease (40.2%), active cancer (15.3%), concomitant anti-platelet use (26.7%), and prior major bleeding (19.7%). During a median follow-up duration of 8 (interquartile range 3–16) months, overall thromboembolic and bleeding events occurred in 16 (2.3%) and 88 (13.1%) patients, respectively. Compared to the expected event rates on the established risk scoring systems, patients receiving very low-dose edoxaban demonstrated a 61% reduction in ischemic stroke, a 68% reduction of ischemic stroke/transient ischemic attack/systemic embolism, whereas a 49% increase in major bleeding.
Conclusions
The prescription of very low-dose edoxaban was increased over time, attributable to various clinical factors. The use of very low-dose edoxaban reduced the expected risk of thromboembolic events.
2.Increasing Very Low-Dose Edoxaban Prescription: Effectiveness and Safety Data of Korean AF Patients
JungMin CHOI ; So-Young YANG ; So-Ryoung LEE ; Min Soo CHO ; Kyung-Yeon LEE ; Hyo-Jeong AHN ; Soonil KWON ; Myung-Jin CHA ; Jun KIM ; Gi-Byoung NAM ; Kee-Joon CHOI ; Eue-Keun CHOI ; Seil OH ; Gregory Y. H. LIP
Korean Circulation Journal 2025;55(3):215-227
Background and Objectives:
Evidence remains limited on the real-world prescription of very low-dose oral anticoagulation among frail patients with atrial fibrillation (AF). We described the practice patterns, effectiveness, and safety of very low-dose edoxaban (15 mg once daily).
Methods:
Patients with AF prescribed edoxaban 15 mg once daily in 2 tertiary hospitals between 2016 and September 2022 were included. Baseline clinical characteristics and clinical outcomes of interest were thromboembolic and bleeding events.
Results:
A total of 674 patients were included (mean age 78.3±9.1, 49.7% aged ≥80 years, 49.3% women, median follow-up 1.0±1.2 years). Mean CHA 2 DS 2 -VASc score was 3.9±1.6, and the modified HAS-BLED score was 2.0±1.1. Between 2016 and 2022, the number of very lowdose edoxaban prescriptions increased. The main reasons for the prescription of very lowdose were low body weight (55.5% below 60 kg), anaemia (62.8%), chronic kidney disease (40.2%), active cancer (15.3%), concomitant anti-platelet use (26.7%), and prior major bleeding (19.7%). During a median follow-up duration of 8 (interquartile range 3–16) months, overall thromboembolic and bleeding events occurred in 16 (2.3%) and 88 (13.1%) patients, respectively. Compared to the expected event rates on the established risk scoring systems, patients receiving very low-dose edoxaban demonstrated a 61% reduction in ischemic stroke, a 68% reduction of ischemic stroke/transient ischemic attack/systemic embolism, whereas a 49% increase in major bleeding.
Conclusions
The prescription of very low-dose edoxaban was increased over time, attributable to various clinical factors. The use of very low-dose edoxaban reduced the expected risk of thromboembolic events.
3.Increasing Very Low-Dose Edoxaban Prescription: Effectiveness and Safety Data of Korean AF Patients
JungMin CHOI ; So-Young YANG ; So-Ryoung LEE ; Min Soo CHO ; Kyung-Yeon LEE ; Hyo-Jeong AHN ; Soonil KWON ; Myung-Jin CHA ; Jun KIM ; Gi-Byoung NAM ; Kee-Joon CHOI ; Eue-Keun CHOI ; Seil OH ; Gregory Y. H. LIP
Korean Circulation Journal 2025;55(3):215-227
Background and Objectives:
Evidence remains limited on the real-world prescription of very low-dose oral anticoagulation among frail patients with atrial fibrillation (AF). We described the practice patterns, effectiveness, and safety of very low-dose edoxaban (15 mg once daily).
Methods:
Patients with AF prescribed edoxaban 15 mg once daily in 2 tertiary hospitals between 2016 and September 2022 were included. Baseline clinical characteristics and clinical outcomes of interest were thromboembolic and bleeding events.
Results:
A total of 674 patients were included (mean age 78.3±9.1, 49.7% aged ≥80 years, 49.3% women, median follow-up 1.0±1.2 years). Mean CHA 2 DS 2 -VASc score was 3.9±1.6, and the modified HAS-BLED score was 2.0±1.1. Between 2016 and 2022, the number of very lowdose edoxaban prescriptions increased. The main reasons for the prescription of very lowdose were low body weight (55.5% below 60 kg), anaemia (62.8%), chronic kidney disease (40.2%), active cancer (15.3%), concomitant anti-platelet use (26.7%), and prior major bleeding (19.7%). During a median follow-up duration of 8 (interquartile range 3–16) months, overall thromboembolic and bleeding events occurred in 16 (2.3%) and 88 (13.1%) patients, respectively. Compared to the expected event rates on the established risk scoring systems, patients receiving very low-dose edoxaban demonstrated a 61% reduction in ischemic stroke, a 68% reduction of ischemic stroke/transient ischemic attack/systemic embolism, whereas a 49% increase in major bleeding.
Conclusions
The prescription of very low-dose edoxaban was increased over time, attributable to various clinical factors. The use of very low-dose edoxaban reduced the expected risk of thromboembolic events.
4.Increasing Very Low-Dose Edoxaban Prescription: Effectiveness and Safety Data of Korean AF Patients
JungMin CHOI ; So-Young YANG ; So-Ryoung LEE ; Min Soo CHO ; Kyung-Yeon LEE ; Hyo-Jeong AHN ; Soonil KWON ; Myung-Jin CHA ; Jun KIM ; Gi-Byoung NAM ; Kee-Joon CHOI ; Eue-Keun CHOI ; Seil OH ; Gregory Y. H. LIP
Korean Circulation Journal 2025;55(3):215-227
Background and Objectives:
Evidence remains limited on the real-world prescription of very low-dose oral anticoagulation among frail patients with atrial fibrillation (AF). We described the practice patterns, effectiveness, and safety of very low-dose edoxaban (15 mg once daily).
Methods:
Patients with AF prescribed edoxaban 15 mg once daily in 2 tertiary hospitals between 2016 and September 2022 were included. Baseline clinical characteristics and clinical outcomes of interest were thromboembolic and bleeding events.
Results:
A total of 674 patients were included (mean age 78.3±9.1, 49.7% aged ≥80 years, 49.3% women, median follow-up 1.0±1.2 years). Mean CHA 2 DS 2 -VASc score was 3.9±1.6, and the modified HAS-BLED score was 2.0±1.1. Between 2016 and 2022, the number of very lowdose edoxaban prescriptions increased. The main reasons for the prescription of very lowdose were low body weight (55.5% below 60 kg), anaemia (62.8%), chronic kidney disease (40.2%), active cancer (15.3%), concomitant anti-platelet use (26.7%), and prior major bleeding (19.7%). During a median follow-up duration of 8 (interquartile range 3–16) months, overall thromboembolic and bleeding events occurred in 16 (2.3%) and 88 (13.1%) patients, respectively. Compared to the expected event rates on the established risk scoring systems, patients receiving very low-dose edoxaban demonstrated a 61% reduction in ischemic stroke, a 68% reduction of ischemic stroke/transient ischemic attack/systemic embolism, whereas a 49% increase in major bleeding.
Conclusions
The prescription of very low-dose edoxaban was increased over time, attributable to various clinical factors. The use of very low-dose edoxaban reduced the expected risk of thromboembolic events.
5.Guideline for Minimizing Radiation Exposure of Interventionalists during Fluoroscopy-guided Interventional Procedures
Il Sang SHIN ; Yun Nah LEE ; Jun Kyu LEE ; Joo Seong KIM ; Sung Bum KIM ; Jiyoung KEUM ; Chang Hoon OH ; Kang Won LEE ; Joowon CHUNG ; Lyo Min KWON ; Nam Hee KIM ; Sang Soo LEE ; Byoung Kwan SON ; Miyoung CHOI
The Korean Journal of Gastroenterology 2024;84(6):251-264
As fluoroscopy-guided interventional procedures gain popularity, the associated health threats from radiation exposure to interventionalists during these procedures are increasing. Therefore, an understanding of the potential risks of radiation and careful consideration on minimizing exposure to radiation during the procedures are of paramount importance. The Korean Pancreatobiliary Association has developed a clinical practice guideline to minimize radiation exposure during fluoroscopy-guided interventional procedures. This guideline provides recommendations to deal with the risk of radiation exposure to interventionalists who perform fluoroscopy-guided procedures, and emphasizes the importance of proper and practical approaches to avoid unnecessary radiation exposure.
6.Guideline for Minimizing Radiation Exposure of Interventionalists during Fluoroscopy-guided Interventional Procedures
Il Sang SHIN ; Yun Nah LEE ; Jun Kyu LEE ; Joo Seong KIM ; Sung Bum KIM ; Jiyoung KEUM ; Chang Hoon OH ; Kang Won LEE ; Joowon CHUNG ; Lyo Min KWON ; Nam Hee KIM ; Sang Soo LEE ; Byoung Kwan SON ; Miyoung CHOI
The Korean Journal of Gastroenterology 2024;84(6):251-264
As fluoroscopy-guided interventional procedures gain popularity, the associated health threats from radiation exposure to interventionalists during these procedures are increasing. Therefore, an understanding of the potential risks of radiation and careful consideration on minimizing exposure to radiation during the procedures are of paramount importance. The Korean Pancreatobiliary Association has developed a clinical practice guideline to minimize radiation exposure during fluoroscopy-guided interventional procedures. This guideline provides recommendations to deal with the risk of radiation exposure to interventionalists who perform fluoroscopy-guided procedures, and emphasizes the importance of proper and practical approaches to avoid unnecessary radiation exposure.
7.Guideline for Minimizing Radiation Exposure of Interventionalists during Fluoroscopy-guided Interventional Procedures
Il Sang SHIN ; Yun Nah LEE ; Jun Kyu LEE ; Joo Seong KIM ; Sung Bum KIM ; Jiyoung KEUM ; Chang Hoon OH ; Kang Won LEE ; Joowon CHUNG ; Lyo Min KWON ; Nam Hee KIM ; Sang Soo LEE ; Byoung Kwan SON ; Miyoung CHOI
The Korean Journal of Gastroenterology 2024;84(6):251-264
As fluoroscopy-guided interventional procedures gain popularity, the associated health threats from radiation exposure to interventionalists during these procedures are increasing. Therefore, an understanding of the potential risks of radiation and careful consideration on minimizing exposure to radiation during the procedures are of paramount importance. The Korean Pancreatobiliary Association has developed a clinical practice guideline to minimize radiation exposure during fluoroscopy-guided interventional procedures. This guideline provides recommendations to deal with the risk of radiation exposure to interventionalists who perform fluoroscopy-guided procedures, and emphasizes the importance of proper and practical approaches to avoid unnecessary radiation exposure.
8.Guideline for Minimizing Radiation Exposure of Interventionalists during Fluoroscopy-guided Interventional Procedures
Il Sang SHIN ; Yun Nah LEE ; Jun Kyu LEE ; Joo Seong KIM ; Sung Bum KIM ; Jiyoung KEUM ; Chang Hoon OH ; Kang Won LEE ; Joowon CHUNG ; Lyo Min KWON ; Nam Hee KIM ; Sang Soo LEE ; Byoung Kwan SON ; Miyoung CHOI
The Korean Journal of Gastroenterology 2024;84(6):251-264
As fluoroscopy-guided interventional procedures gain popularity, the associated health threats from radiation exposure to interventionalists during these procedures are increasing. Therefore, an understanding of the potential risks of radiation and careful consideration on minimizing exposure to radiation during the procedures are of paramount importance. The Korean Pancreatobiliary Association has developed a clinical practice guideline to minimize radiation exposure during fluoroscopy-guided interventional procedures. This guideline provides recommendations to deal with the risk of radiation exposure to interventionalists who perform fluoroscopy-guided procedures, and emphasizes the importance of proper and practical approaches to avoid unnecessary radiation exposure.
9.Guideline for Minimizing Radiation Exposure of Interventionalists during Fluoroscopy-guided Interventional Procedures
Il Sang SHIN ; Yun Nah LEE ; Jun Kyu LEE ; Joo Seong KIM ; Sung Bum KIM ; Jiyoung KEUM ; Chang Hoon OH ; Kang Won LEE ; Joowon CHUNG ; Lyo Min KWON ; Nam Hee KIM ; Sang Soo LEE ; Byoung Kwan SON ; Miyoung CHOI
The Korean Journal of Gastroenterology 2024;84(6):251-264
As fluoroscopy-guided interventional procedures gain popularity, the associated health threats from radiation exposure to interventionalists during these procedures are increasing. Therefore, an understanding of the potential risks of radiation and careful consideration on minimizing exposure to radiation during the procedures are of paramount importance. The Korean Pancreatobiliary Association has developed a clinical practice guideline to minimize radiation exposure during fluoroscopy-guided interventional procedures. This guideline provides recommendations to deal with the risk of radiation exposure to interventionalists who perform fluoroscopy-guided procedures, and emphasizes the importance of proper and practical approaches to avoid unnecessary radiation exposure.
10.C3 glomerulonephritis with genetically confirmed C3 deficiency in a pediatric patient: a case report
Hae Min KIM ; Jae Il SHIN ; Ji Hong KIM ; Jiyoung OH ; Ji-Man KANG ; Hee Gyung KANG ; Seong Heon KIM ; Byoung Soo CHO ; Keum Hwa LEE
Childhood Kidney Diseases 2024;28(3):124-130
Complement component 3 glomerulonephritis (C3GN) is a rare kidney disease characterized by complement dysregulation that results in prominent complement component 3 (C3) deposition in the kidneys. The clinical course of C3GN varies from mild hematuria to progressive chronic kidney disease. In most patients, C3GN is driven by acquired factors, namely, autoantibodies that target C3 or C5 convertases. Genetic variations in complement-related genes are less frequent. We report the case of a 9-yearold Korean boy who presented with microscopic hematuria and a persistently low C3 level and had biopsy findings of C3GN, with the presence of a C3 gene mutation: a frameshift mutation associated with C3 deficiency. However, the patient did not exhibit any other symptoms of complement deficiency. Direct DNA sequencing of his family members revealed the same genetic mutation in his father and older brother. This case report is significant because there are very few such reports worldwide concerning gene mutations related to C3 deficiency to be discovered in patients with C3GN. Explaining C3GN pathogenesis is challenging; therefore, additional research is required in the future.

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