Clinical characteristics and outcomes of dialysis patients with atrial fibrillation: the Fushimi AF Registry

被引:13
作者
Yamashita, Yugo [1 ]
Takagi, Daisuke [2 ]
Hamatani, Yasuhiro [3 ]
Iguchi, Moritake [2 ]
Masunaga, Nobutoyo [2 ]
Esato, Masahiro [4 ]
Chun, Yeong-Hwa [4 ]
Itoh, Hitoshi [5 ]
Nishimura, Masato [6 ]
Wada, Hiromichi [7 ]
Hasegawa, Koji [7 ]
Ogawa, Hisashi [2 ]
Abe, Mitsuru [2 ]
Akao, Masaharu [2 ]
机构
[1] Kyoto Univ, Grad Sch Med, Dept Cardiovasc Med, Kyoto, Japan
[2] Natl Hosp Org Kyoto Med Ctr, Dept Cardiol, Fushimi Ku, 1-1 Mukaihata Cho, Kyoto 6128555, Japan
[3] Natl Cerebral & Cardiovasc Ctr, Div Heart Failure, Osaka, Japan
[4] Ijinkai Takeda Gen Hosp, Dept Arrhythmia, Kyoto, Japan
[5] Itoh Hemodialysis Clin, Kyoto, Japan
[6] Toujinkai Hosp, Cardiovasc Div, Kyoto, Japan
[7] Natl Hosp Org Kyoto Med Ctr, Div Translat Res, Kyoto, Japan
关键词
Atrial fibrillation; Dialysis; Stroke; Bleeding; Oral anticoagulant; STAGE RENAL-DISEASE; CHRONIC KIDNEY-DISEASE; HEMODIALYSIS-PATIENTS; RISK-FACTORS; WARFARIN INITIATION; PREDICTING STROKE; ISCHEMIC-STROKE; BLEEDING RISK; ANTICOAGULATION; MORTALITY;
D O I
10.1007/s00380-016-0818-x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Atrial fibrillation (AF) is common in dialysis patients. However, clinical characteristics and outcomes of dialysis patients with AF are poorly understood. The Fushimi AF Registry is a community-based prospective survey of AF patients in Japan. Follow-up data were available for 3713 patients with a median follow-up of 2.8 years. We compared clinical characteristics and outcomes between the dialysis group (n = 92; 2.5 %) and others. The dialysis group had more various co-morbidities, with a mean CHADS(2) score of 2.5, and the rate of warfarin prescription was 38 %. The annual incidence rates of stroke or systemic embolism (SE), major bleeding, and all-cause death in the dialysis group were 4.0, 5.1, and 20.9 per 100 person-years, respectively. There was no significant difference in the incidence rate of stroke/SE between the dialysis group and the non-dialysis group [hazard ratio (HR) 1.74 (95 % confidence interval (CI) 0.74-3.42)]. The incidence rates of major bleeding, all-cause death, and the composite of stroke/SE and all-cause death in the dialysis group were higher than those in the non-dialysis group [major bleeding: HR 3.09 (95 % CI 1.46-5.72), all-cause death: HR 3.51 (95 % CI 2.48-4.81), the composite of stroke/SE and all-cause death: HR 2.99 (95 % CI 2.15-4.05)]. Among dialysis patients, warfarin did not affect major clinical events including stroke/SE, bleeding or all-cause death. Among AF patients, those receiving dialysis showed higher incidence of major bleeding and all-cause death compared with non-dialysis patients, but the risk of stroke/SE was not particularly high. URL: www.umin.ac.jp/ctr/index.htm http://www.umin.ac.jp/ctr/index.htm" TargetType="URL.
引用
收藏
页码:2025 / 2034
页数:10
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