Regional Differences in Frequency of Warfarin Therapy and Thromboembolism in Japanese Patients With Non-Valvular Atrial Fibrillation - Analysis of the J-RHYTHM Registry

被引：6

作者：

Inoue, Hiroshi ^{[1
]}

Atarashi, Hirotsugu ^{[2
]}

Kodani, Eitaro ^{[2
]}

Okumura, Ken ^{[3
]}

Yamashita, Takeshi ^{[4
]}

Origasa, Hideki ^{[5
]}

Sakurai, Masayuki ^{[6
]}

Kawamura, Yuichiro ^{[7
]}

Kubota, Isao ^{[8
]}

Matsumoto, Kazuo ^{[9
]}

Kaneko, Yoshiaki ^{[10
]}

Ogawa, Satoshi ^{[11
]}

Aizawa, Yoshifusa ^{[12
]}

Chinushi, Masaomi ^{[13
]}

Kodama, Itsuo ^{[14
]}

Watanabe, Eiichi ^{[15
]}

Koretsune, Yukihiro ^{[16
]}

Okuyama, Yuji ^{[17
]}

Shimizu, Akihiko ^{[18
]}

Igawa, Osamu ^{[19
]}

Bando, Shigenobu ^{[20
]}

Fukatani, Masahiko ^{[21
]}

Saikawa, Tetsunori ^{[22
]}

Chishaki, Akiko ^{[23
]}

机构：

[1] Toyama Univ Hosp, Dept Internal Med 2, Toyama, Japan

[2] Tama Nagayama Hosp, Nippon Med Sch, Tokyo, Japan

[3] Hirosaki Univ, Grad Sch Med, Dept Cardiol, Hirosaki, Aomori, Japan

[4] Cardiovasc Inst, Tokyo, Japan

[5] Toyama Univ, Div Biostat & Clin Epidemiol, Toyama 930, Japan

[6] Hokko Mem Hosp, Dept Cardiol, Sapporo, Hokkaido, Japan

[7] Asahikawa Med Univ, Hlth Adm Ctr, Asahikawa, Hokkaido, Japan

[8] Yamagata Univ, Sch Med, Internal Med 1, Yamagata 99023, Japan

[9] Saitama Med Univ, Dept Cardiol, Int Med Ctr, Saitama, Japan

[10] Gunma Univ, Grad Sch Med, Dept Med & Biol Sci, Maebashi, Gunma 371, Japan

[11] Int Univ Hlth & Welf, Mita Hosp, Tokyo, Japan

[12] Niigata Univ, Grad Sch Med & Dent Sci, Div Cardiol, Niigata, Japan

[13] Niigata Univ, Sch Med, Grad Sch Hlth Sci, Niigata, Japan

[14] Nagoya Univ, Nagoya, Aichi, Japan

[15] Fujita Hlth Univ, Sch Med, Dept Cardiol, Toyoake, Aichi, Japan

[16] Osaka Natl Hosp, Natl Hosp Org, Inst Clin Res, Osaka, Japan

[17] Osaka Gen Med Ctr, Dept Cardiol, Osaka, Japan

[18] Yamaguchi Grad Sch Med, Fac Hlth Sci, Ube, Yamaguchi, Japan

[19] Tottori Univ Hosp, Dept Cardiovasc Med, Yonago, Tottori, Japan

[20] Kagawa Prefectural Shirotori Hosp, Kagawa, Japan

[21] Chikamori Hosp, Dept Cardiol, Kochi, Japan

[22] Oita Univ, Dept Clin Examinat & Diagnost, Oita, Japan

[23] Kyushu Univ, Dept Hlth Sci, Fac Med Sci, Fukuoka, Japan

来源：

CIRCULATION JOURNAL | 2016年 / 80卷 / 07期

关键词：

Atrial fibrillation; Major hemorrhage; Region; Thromboembolism; Warfarin; BASE-LINE DATA; STROKE PREVENTION; EVENTS; ASIA; SUBANALYSIS; REDUCTION; APIXABAN; EFFICACY; PATTERNS; INSIGHTS;

D O I：

10.1253/circj.CJ-16-0300

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: The proportion of patients with atrial fibrillation (AF) treated with anticoagulation varies from country to country. In Japan, little is known about regional differences in frequency of warfarin use or prognosis among patients with non-valvular AF (NVAF). Methods and Results: In J-RHYTHM Registry, the number of patients recruited from each of 10 geographic regions of Japan was based on region population density. A total of 7,406 NVAF patients were followed up prospectively for 2 years. At baseline, significant differences in various clinical characteristics including age, sex, type of AF, comorbidity, and CHADS(2) score, were detected among the regions. The highest mean CHADS(2) score was recorded in Shikoku. Frequency of warfarin use differed between the regions (P<0.001), with lower frequencies observed in Hokkaido and Shikoku. Baseline prothrombin time international normalized ratio differed slightly but significantly between the regions (P<0.05). On univariate analysis, frequency of thromboembolic events differed among the regions (P<0.001), with the highest rate seen in Shikoku. An inverse correlation was detected between frequency of thromboembolic and of major hemorrhagic events (P=0.062). On multivariate analysis, region emerged as an independent risk for thromboembolism. Conclusions: Thromboembolic risk, frequency of warfarin use, and intensity and quality of warfarin treatment differed significantly between geographic regions of Japan. Region was found to be an independent predictor of thromboembolic events.

引用

页码：1548 / 1555

页数：8

共 25 条

[1] Insights Into Management of Atrial Fibrillation in Asia Pacific Gained From Baseline Data from REgistry on Cardiac rhythm disORDers (RecordAF-Asia Pacific [AP]) Registry [J].

Amerena, John ;

Chen, Shih-Ann ;

Sriratanasathavorn, Charn ;

Cho, Jeong-Gwan ;

Huang, Dejia ;

Omar, Razali ;

Tse, Hung Fat ;

King, Anthony .

AMERICAN JOURNAL OF CARDIOLOGY, 2012, 109 (03) :378-382

[2] Present Status of Anticoagulation Treatment in Japanese Patients With Atrial Fibrillation - A Report From the J-RHYTHM Registry [J].

Atarashi, Hirotsugu ;

Inoue, Hiroshi ;

Okumura, Ken ;

Yamashita, Takeshi ;

Kumagai, Naoko ;

Origasa, Hideki .

CIRCULATION JOURNAL, 2011, 75 (06) :1328-1333

[3] Investigation of optimal anticoagulation strategy for stroke prevention in Japanese patients with atrial fibrillation-The J-RHYTHM Registry study design [J].

Atarashi, Hirotsugu ;

Inoue, Hiroshi ;

Okumura, Ken ;

Yamashita, Takeshi ;

Origasa, Hideki .

JOURNAL OF CARDIOLOGY, 2011, 57 (01) :95-99

[4] Validation of clinical classification schemes for predicting stroke - Results from the national registry of Atrial Fibrillation [J].

Gage, BF ;

Waterman, AD ;

Shannon, W ;

Boechler, M ;

Rich, MW ;

Radford, MJ .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2001, 285 (22) :2864-2870

[5] Apixaban versus warfarin in patients with atrial fibrillation according to prior warfarin use: Results from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation trial [J].

Garcia, David A. ;

Wallentin, Lars ;

Lopes, Renato D. ;

Thomas, Laine ;

Alexander, John H. ;

Hylek, Elaine M. ;

Ansell, Jack ;

Hanna, Michael ;

Lanas, Fernando ;

Flaker, Greg ;

Commerford, Patrick ;

Xavier, Denis ;

Vinereanu, Dragos ;

Yang, Hongqiu ;

Granger, Christopher B. .

AMERICAN HEART JOURNAL, 2013, 166 (03) :549-558

[6] Edoxaban versus Warfarin in Patients with Atrial Fibrillation [J].

Giugliano, Robert P. ;

Ruff, Christian T. ;

Braunwald, Eugene ;

Murphy, Sabina A. ;

Wiviott, Stephen D. ;

Halperin, Jonathan L. ;

Waldo, Albert L. ;

Ezekowitz, Michael D. ;

Weitz, Jeffrey I. ;

Spinar, Jindrich ;

Ruzyllo, Witold ;

Ruda, Mikhail ;

Koretsune, Yukihiro ;

Betcher, Joshua ;

Shi, Minggao ;

Grip, Laura T. ;

Patel, Shirali P. ;

Patel, Indravadan ;

Hanyok, James J. ;

Mercuri, Michele ;

Vogelmann, O. ;

Gonzalez, C. ;

Ahuad Guerrero, R. ;

Rodriguez, M. ;

Albisu, J. ;

Rosales, E. ;

Allall, O. ;

Reguero, M. ;

Alvarez, C. ;

Garcia, M. ;

Ameriso, S. ;

Ameriso, P. ;

Amuchastegui, M. ;

Caceres, M. ;

Beloscar, J. ;

Petrucci, J. ;

Berli, M. ;

Budassi, N. ;

Valle, M. ;

Bustamante Labarta, G. ;

Saravia, M. ;

Caccavo, A. ;

Fracaro, V. ;

Cartasegna, L. ;

Novas, V. ;

Caruso, O. ;

Saa Zarandon, R. ;

Colombo, H. ;

Morandini, M. ;

Cuello, J. .

NEW ENGLAND JOURNAL OF MEDICINE, 2013, 369 (22) :2093-2104

[7] Efficacy and Safety of Apixaban Compared with Warfarin for Stroke Prevention in Patients with Atrial Fibrillation from East Asia: A Subanalysis of the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) Trial [J].

Goto, Shinya ;

Zhu, Jun ;

Liu, Lisheng ;

Oh, Byung-Hee ;

Wojdyla, Daniel M. ;

Aylward, Philip ;

Bahit, M. Cecilia ;

Gersh, Bernard J. ;

Hanna, Michael ;

Horowitz, John ;

Lopes, Renato D. ;

Wallentin, Lars ;

Xavier, Denis ;

Alexander, John H. .

AMERICAN HEART JOURNAL, 2014, 168 (03) :303-309

[8] Dabigatran Versus Warfarin Effects on Ischemic and Hemorrhagic Strokes and Bleeding in Asians and Non-Asians With Atrial Fibrillation [J].

Hori, Masatsugu ;

Connolly, Stuart J. ;

Zhu, Jun ;

Liu, Li Sheng ;

Lau, Chu-Pak ;

Pais, Prem ;

Xavier, Denis ;

Kim, Sung Soon ;

Omar, Razali ;

Dans, Antonio L. ;

Tan, Ru San ;

Chen, Jyh-Hong ;

Tanomsup, Supachai ;

Watanabe, Mitsunori ;

Koyanagi, Masahide ;

Ezekowitz, Michael D. ;

Reilly, Paul A. ;

Wallentin, Lars ;

Yusuf, Salim .

STROKE, 2013, 44 (07) :1891-+

[9] Antithrombotic Treatment Patterns in Patients with Newly Diagnosed Nonvalvular Atrial Fibrillation: The GLORIA-AF Registry, Phase II [J].

Huisman, Menno V. ;

Rothman, Kenneth J. ;

Paquette, Miney ;

Teutsch, Christine ;

Diener, Hans Christoph ;

Dubner, Sergio J. ;

Halperin, Jonathan L. ;

Ma, Changsheng ;

Zint, Kristina ;

Elsaesser, Amelie ;

Bartels, Dorothee B. ;

Lip, Gregory Y. H. .

AMERICAN JOURNAL OF MEDICINE, 2015, 128 (12) :1306-+

[10] Thromboembolic Events in Paroxysmal vs. Permanent Non-Valvular Atrial Fibrillation - Subanalysis of the J-RHYTHM Registry [J].

Inoue, Hiroshi ;

Atarashi, Hirotsugu ;

Okumura, Ken ;

Yamashita, Takeshi ;

Kumagai, Naoko ;

Origasa, Hideki .

CIRCULATION JOURNAL, 2014, 78 (10) :2388-2393

← 1 2 3 →