Shao-Wei Chen

Chang Gung Memorial Hospital | CGMH · Division of Thoracic and Cardiovascular Surgery

OBJECTIVE: The objective of the study was to evaluate the effects of β-blocker therapy on long-term outcomes in patients after surgical repair of type A aortic dissection. METHODS: A total of 4275 patients with acute type A aortic dissection who underwent surgical repair between 2004 and 2013, were identified using the Taiwan National Health Insur...

Background Rheumatic heart disease (RHD) remains a major cause of cardiovascular death worldwide. Limited real-world nationwide data are available to compare the long-term outcomes between mitral valve (MV) repair and replacement in RHD. Methods We identified adult patients with RHD who underwent MV repair or replacement surgery between 2000 and 2...

Background Aortic dissection (AD) is a life-threatening emergency. However, the heritability and association of family history with late outcomes are unclear. Objectives The purpose of this study was to evaluate the effect of family history of AD on the incidence and prognosis of AD and estimate the heritability and environmental contribution in A...

Background Recent population-based studies have revealed that the use of fluoroquinolones (FQs) is associated with an increased risk of aortic dissection (AD) and aneurysm (AA). However, no evidence is available on whether FQs increase adverse events in patients who had been diagnosed with AD or AA. Objectives This study investigated whether the u...

Objectives The feasibility and long-term outcomes of mitral valve (MV) repair in patients with infective endocarditis (IE) remain unclear. Methods Using Taiwan’s National Health Insurance Research Database, we identified 1,999 patients who underwent MV surgery for IE during 2000–2013. The patients were more likely to have undergone valve replaceme...

Background The risk of cardiac dysfunction for patients with prostate cancer undergoing androgen deprivation therapy (ADT) in the real‐world setting remains unclear. Methods and Results A total of 1120 patients with prostate cancer and a baseline echocardiography scan were identified from Chang Gung Research Database between January 1, 2001 and De...

Background and Aims Limited real-world data show that rivaroxaban following dosage criteria from either ROCKET AF (20mg/day or 15mg/day if creatinine clearance [CrCl]<50ml/min) or J-ROCKET AF (15mg/day or 10mg/day if CrCl<50ml/min) are associated with comparable risks of thromboembolism and bleeding with each other in patients with non-valvular atr...

Background: In Taiwan, infective native aortic aneurysms (INAAs) are relatively common, so the aim of present study was to demonstrate the comparative outcomes of endovascular repair for thoracic and abdominal INAAs. Methods and Results: Patients with naïve thoracic or abdominal INAAs managed with endovascular repair between 2001 and 2018 were incl...

Aims: The ELDERCARE-AF trial showed that edoxaban at a very-low-dosage (VLD) of 15 mg/day was more effective than a placebo at preventing stroke/systemic embolism without significantly increasing the risk of serious bleeding. We aimed to compare the effectiveness and safety for VLD non-vitamin K antagonist oral anticoagulants (NOACs) (edoxaban 15...

Background: Scrub typhus is an infectious disease that affects multiple organs. However, the long-term cardiovascular (CV) risk in survivors remains unknown. Method: A retrospective cohort study used administrative claims data from the National Health Insurance Research Database (NHIRD) to investigate the CV risk of scrub typhus survivors from Janu...

Background: Biologic prostheses are being increasingly used for aortic and mitral valve replacement (AVR and MVR). This study evaluated the long-term durability of bioprosthetic valves in the mitral and aortic positions, as no well-designed population-based studies have addressed this issue before. Methods: Using Taiwan's National Health Insuran...

Preoperative renal dysfunction is associated with mortality in patients with acute type A aortic dissection (ATAAD) repair. However, the long-term outcome of chronic kidney dysfunction (CKD) in ATAAD is unclear. The study aimed to evaluate the long-term outcome of CKD in patients with ATAAD repair. We retrospectively studied patients with ATAAD rep...

Background Chronic hepatitis C virus (HCV) infection is associated with increased cardiovascular risks. We aimed to investigate the impact of direct acting antiviral (DAA) on HCV-associated cardiovascular events. Methods In this retrospective cohort study, patients with the diagnosis of chronic HCV were retrieved from multi-institutional electroni...

Objective: There is limited evidence regarding the association between myocardial function and long-term survival rate in patients who reach hospital discharge. This study aimed to investigate the association between myocardial function parameters collected at different times from weaning to long-term follow-up and the long-term mortality rate. Met...

Background: Studies of the influence of smaller body type on the severity of prosthesis-patient mismatch (PPM) after small-sized surgical aortic valve replacement (SAVR) are few, but the issue is particularly relevant for Asian patients. Methods and Results: 695 patients who underwent SAVR with bioprosthetic valves had their hemodynamic valve perfo...

Background: To determine whether background medications modify the effects of sodium-glucose cotransporter-2 inhibitor (SGLT2i) on the estimated glomerular filtration rate (eGFR) and kidney outcomes among patients with type 2 diabetes. Methods: We used medical data from a multicenter health-care facility in Taiwan and included 10,071 patients wh...

Aims Limited data compared antiarrhythmic drugs (AADs) with concomitant non-vitamin K antagonist oral anticoagulants in atrial fibrillation patients, hence the aim of the study. Methods and results National health insurance database were retrieved during 2012–17 for study. We excluded patients not taking AADs, bradycardia, heart block, heart failu...

Background The impact of sex-related differences in patients receiving extracorporeal membrane oxygenation support (ECMO) support is still inconclusive. This population-based study aimed to investigate sex differences in short- or long-term outcomes in order to improve clinical practice. Methods Patients who received ECMO between 2001 to 2017 were...

There is scarce evidence about the surgeon learning curve of acute type A aortic dissection surgery and whether the optimal procedure number exists when training a cardiovascular surgeon. A total of 704 patients with acute type A aortic dissection surgery performed by 17 junior surgeons who can identify their first career surgery from January 1, 20...

Epidemiological studies have reported an association between chronic cadmium (Cd) exposure and increased cardiovascular risk; however, their causal relationship remains unclear. The aim of this study is to explore the effects of Cd exposure on the cardiac and arterial systems in mice. According to the concentration of cadmium chloride in drinking w...

Background: Fluoroquinolone use can be associated with an increased risk of aortic aneurysm (AA) or aortic dissection (AD). The US Food and Drug Administration recently warned against fluoroquinolone use for high-risk patients, such as those with Marfan syndrome. However, the association between fluoroquinolone use and AA/AD risk was unknown in the...

Background: Atrial fibrillation is the most common cardiac arrythmia and causes many complications. Sinus rhythm restoration could reduce late mortality of atrial fibrillation patients. The Maze procedure is the gold standard for surgical ablation of atrial fibrillation. Higher surgical volume has been documented with favorable outcomes of various...

The comparison of clinical effectiveness and safety across different nonvitamin K antagonist direct oral anticoagulants (DOACs) in Asian patients with venous thromboembolism (VTE) remains unclear. Therefore, we assessed the real-world benefits of different DOACs in these patients. A cohort of 1480 patients with VTE were identified from the Chang Gu...

Importance There are emerging concerns from case reports and pharmacovigilance analyses of a possible risk of interstitial lung disease (ILD) associated with the use of factor Xa (FXa) inhibitors. Objective To evaluate the risk of incident ILD associated with the use of oral anticoagulants (OACs) in patients with nonvalvular atrial fibrillation (N...

Background: Blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) are important risk factors for cardiovascular (CV) diseases. Although treating these factors simultaneously is recommended by current guidelines, only short-term clinical results are available. Objectives: To examine the longer-term efficacy and safety of fixed-dose...

Background The echocardiographic parameter E/e’ has been associated with cardiovascular (CV) events. However, few studies have analyzed multiple associated CV outcomes using E/e’ in a diverse population of both inpatients and outpatients with and without cardiac diseases and risk factors. Methods Medical records of 75,393 patients without atrial f...

Background: In modern critical care, extracorporeal membrane oxygenation (ECMO) is crucial in the management of severe respiratory and cardiac failure. Nationwide studies of the relationship between hospital volume and outcomes of ECMO use are unavailable.Methods and Results: Using Taiwan's National Health Insurance Research Database, we identifie...

BACKGROUND The long-term outcomes of surgical ablation for atrial fibrillation during cardiac surgery remain unclear. METHODS This nationwide population-based retrospective cohort study used data from Taiwan’s National Health Insurance Research Database. Overall, 11,459 patients undergoing coronary artery bypass graft, valve, or aortic surgery and...

Objects: Cardiac surgery is associated with acute kidney injury (AKI). However, the effects of various pharmacological and non-pharmacological strategies for AKI prevention have not been thoroughly investigated, and their effectiveness in preventing AKI-related adverse outcomes has not been systematically evaluated. Methods: Studies from PubMed, E...

Background: Sodium-glucose co-transporter 2 (SGLT2) inhibitors has been shown with cardiovascular benefit in type 2 diabetes mellitus (T2DM) patients. However, its osmotic diuresis still concern physicians with possible electrolyte imbalance. We therefore aimed to investigate electrocardiographic (ECG) changes associated with SGLT2 inhibitors. Meth...

Background The aim of this study was to investigate the relationship between day-1 urine cadmium excretion and 30-day mortality in patients with acute myocardial infarction (AMI) at two centers. Methods A total of 286 patients (222 males and 64 females) with AMI from Huashan Hospital, Shanghai and Chang Gung Memorial Hospital, Taiwan were enrolled...

Acute kidney injury (AKI) is a common syndrome characterized by various etiologies and pathophysiologic processes that deteriorate kidney function. The aim of this study is to identify potential biomarkers in the urine of non-acute kidney injury (non-AKI) and AKI patients through Raman spectroscopy (RS) to predict the advancement in complications a...

Aims The frequency of an acute increase in serum creatinine (sCr) of >30%, following treatment of sodium-glucose cotransporter-2 inhibitors (SGLT2i) and its clinical implications in patients with type 2 diabetes remains unclear. Methods and Results We used medical data from a multicenter health care provider in Taiwan and recruited 11,657 and 8,11...

Purpose Whether sodium–glucose cotransporter 2 inhibitors (SGLT2is) are associated with lower risk of new-onset atrial fibrillation (AF) compared with glucagon-like peptide-1 receptor agonists (GLP-1RAs) in patients with type 2 diabetes was unknown. Methods We used medical data from a multicentre health care provider in Taiwan and enrolled 16,566...

Background: Although a few meta-analyses were conducted to compare the risk of incident atrial fibrillation (AF) between sodium-glucose cotransporter-2 inhibitor (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1RA), and other anti-hyperglycemic agents using indirect or direct comparison, the above analyses showed conflicting results with...

Background: The risk for major adverse cardiovascular events (MACE) with targeted therapies for patients with advanced renal cell carcinoma (RCC) in real-world practice remains unclear. Objectives: The aim of this study was to compare the risk for MACE associated with targeted cancer therapies with that associated with cytokine treatment in pati...

This study evaluated the risk of major bleeding associated with concomitant use of direct oral anticoagulant (DOAC) and anticancer drugs (ACDs), which share metabolic pathways, in patients with atrial fibrillation (AF) and cancer. We performed a retrospective cohort study using Taiwan’s National Health Insurance database and included patients with...

Objective : Hemoglobin levels and platelet counts have been associated with adverse clinical outcomes in patients with cardiovascular conditions. We aimed to assess the impact of oral anticoagulant use for patients with atrial fibrillation and concomitant anemia and/or thrombocytopenia. Methods : We used medical data from a multi-center healthcare...

No study has evaluated the effect of dexmedetomidine in patients who received surgery for type A aortic dissection. This is the first study to evaluate the effect of dexmedetomidine in aortic dissection patients. This study was executed using data from the Chang Gung Research Database in Taiwan. The CGRD contains the multi‐institutional standardize...

Objective The aim of this study is to evaluate the sex-related differences on the risks of perioperative and late outcomes for adult acute aortic dissection (AAD) patients following surgical management. Methods and results By using Taiwan National Health Insurance Research Database, totally 1,410 female and 3,432 male patients were identified to f...

Importance: Current international normalized ratio (INR) guidelines are based on trials involving European and US populations. To our knowledge, no adequate study involving Asian patients has been conducted to date. Objective: To evaluate the association between INR and anticoagulation-related outcomes in an Asian population after mechanical aor...

Objectives Outcomes of sex differences in major cardiac surgery remain controversial. A comprehensive understanding of sex differences in major adult cardiac surgery could provide better knowledge of risk factors, management strategy and short-term or long-term outcomes. The present study aimed to investigate sex differences in the risks of outcome...

Objectives For the endovascular intervention of acute ischemic stroke, a transcervical route is an alternative approach in patients with challenging anatomical variations. Percutaneous puncture is a common way, but it can cause many fatal complications. Direct carotid artery exposure is an alternative for reducing complications. We demonstrate a te...

Introduction AKD represents a continuum of kidney injury for 7–90 days after acute kidney injury. The incidence and prognosis of AKD after ADHF are currently unclear. The aims of this study were to explore the incidence of AKD and the transition from AKI to AKD, to identify risk factors for AKD and develop a prediction model for any-stage AKD, and...

Background Blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) are important risk factors for cardiovascular (CV) diseases and treating these factors simultaneously is recommended by current guidelines but only short-term clinical results were available. The objective of this study was to examine the longer-term efficacy and safety...

Introduction: Non-vitamin K antagonist oral anticoagulant (NOAC) do not normally require INR-monitoring. We aimed to investigate drug-drug interactions of NOACs in patients with atrial fibrillation (AF) using antiarrhythmic drugs. Hypothesis: Dronedarone may have less drug-drug interaction compared to non-dronedarone antiarrhythmic drugs. Methods:...

Introduction: Dronedarone was developed to improve outcomes in patients with atrial fibrillation (AF) compared with other antiarrhythmic drugs. Hypothesis: Dronedarone may offer better cardiovascular outcomes compared to non-dronedarone antiarrhythmic drugs. Methods: Taiwan National Health Insurance Research Database were retrieved between 2012-201...

Background The effectiveness and safety of initiating sacubitril/valsartan therapy among patients who are hospitalized for acute heart failure (HF) is unclear. Methods A cohort of 3736 patients with HF with reduced ejection fraction (HFrEF) hospitalized for acute HF was identified from Chang Gung Research Database between January 1, 2016 and Augus...

Acute kidney disease (AKD) is the persistence of renal injury between days 8 and 90 after an initial acute kidney injury (AKI). In this study, we aimed to explore the incidence of AKD, the association between AKD, and patient outcomes after acute type A aortic dissection (type A AAD) surgery. We identified 696 participants who underwent type A AAD...

The cover image is based on the Original Article Impact of the initial decline in estimated glomerular filtration rate on the risk of new‐onset atrial fibrillation and adverse cardiovascular and renal events in patients with type 2 diabetes treated with sodium‐glucose co‐transporter‐2 inhibitors by Yi‐Hsin Chan et al., https://doi.org/10.1111/dom.1...

Background: To determine the relationship between hospital surgical volume and mortality risk and valve repair rate in infective endocarditis (IE) surgery. Methods: Using the Taiwan National Health Insurance Research Database (NHIRD), 3873 patients were identified who underwent surgery between 2000 and 2013. The cumulative hospital volume of val...

Objective: This study assesses the mortality outcomes of non-vitamin K antagonist oral anticoagulants (NOACs) in cancer patients with venous thromboembo-lism (VTE) and atrial fibrillation (AF). Methods: Medical records of cancer patients receiving NOACs for VTE or AF between January 1, 2011, and December 31, 2016, were retrieved from Taiwan's Natio...

Abstract Background There is a controversy over the association between obesity and the risk of renal events in patients with type 2 diabetes mellitus (T2DM). Furthermore, whether body weight (BW) loss following sodium glucose cotransporter 2 inhibitor (SGLT2i) treatment associated with risk of adverse renal events is unknown. Methods We used medic...

Globally, 32% to 70% patients with atrial fibrillation (AF) are prescribed oral anticoagulants (OACs) with warfarin for stroke prevention. However, patients with AF on OACs may experience intracranial hemorrhage (ICH), which presents a treatment dilemma. We therefore investigated whether resuming OACs in these patients is beneficial. Electronic med...

Therefore, in contrast to the opinion expressed in the letter, more robust evidence is required to support FQ use as first-line antibiotics in patients with high AA/AD risks. As we had concluded, FQs should not be used in patients with AA/AD unless no other treatment op- tions are available.

The cover image is based on the Original Article Impact of the initial decline in estimated glomerular filtration rate on the risk of new-onset atrial fibrillation and adverse cardiovascular and renal events in patients with type 2 diabetes treated with sodium-glucose co-transporter-2 inhibitors by Yi-Hsin Chan et al., https://doi.org/10.1111/dom.1...

As we had concluded, FQs should not be used in patients with AA/AD unless no other treatment options are available.

Introduction Aortic dissection (AD) is a life-threatening emergency, and lumican (LUM) is a potential Biomarker for AD diagnosis. We investigated LUM expression patterns in patients with AD and explored the molecular functions of Lum in AD mice model. Methods LUM expression patterns were analyzed using aortic tissues of AD patients, and serum solu...

Background and Purpose Data on clinical outcomes for nonvitamin K antagonist oral anticoagulant (NOACs) and warfarin in patients with atrial fibrillation and cancer are limited, and patients with active cancer were excluded from randomized trials. We investigated the effectiveness and safety for NOACs versus warfarin among patients with atrial fibr...

Background We aimed to determine whether cardiovascular (CV) risk in patients with prostate cancer (PCa) differs between those who receive gonadotropin-releasing hormone (GnRH) agonist (GnRHa) therapy and those who receive GnRH antagonist therapy. Methods Using the Taiwan National Health Insurance Research Database, we analyzed data by comparing 6...

Urinary liver-type fatty acid binding protein (L-FABP) is a novel biomarker with promising performance in detecting kidney injury. Previous studies reported that L-FABP showed moderate discrimination in patients that underwent cardiac surgery, and other studies revealed that longer duration of cardiopulmonary bypass (CPB) was associated with a high...

BACKGROUND: Benefits of patients with end-stage renal disease and atrial fibrillation undergoing peritoneal dialysis (PD) or hemodialysis are unknown. METHODS AND RESULTS: Patients undergoing dialysis were retrieved from Taiwan National Health Insurance Research Database during 2001 to 2013 and separated into PD or hemodialysis. Primary outcomes we...

Aim: Sodium-glucose cotransporter 2 inhibitors (SGLT2is) cause an initial decline in estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes mellitus (T2DM). The effect of different eGFR decline following SGLT2i treatment on risks of atrial fibrillation (AF), cardiovascular, and renal events in patients with T2DM are unknown....

Abstract Background Sodium–glucose cotransporter 2 inhibitor (SGLT2i) use reduces body weight (BW) in patients with type 2 diabetes mellitus (T2DM). Obesity and T2DM are strong risk factors of new-onset atrial fibrillation (AF). However, whether BW loss following SGLT2i treatment reduces AF risk in patients with T2DM remains unclear. Methods We use...

Background Dialysis‐requiring acute kidney injury (D‐AKI) is a major complication of cardiovascular surgery that results in worse prognosis. However, the incidence and impacts of D‐AKI in different types of cardiac surgeries have not been fully investigated. Methods and Results Patients admitted for cardiovascular surgery between July 1, 2004, and...