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Predictors for Stroke and Death in Non-Anticoagulated Asian Patients with Atrial Fibrillation: The Fushimi AF Registry.

Hamatani Y, Yamashita Y, Esato M, Chun YH, Tsuji H, Wada H, Hasegawa K, Abe M, Lip GY, Akao M - PLoS ONE (2015)

Bottom Line: Follow-up data were available for 3,304 patients (median follow-up period 741 days).The mean age was 73.1 ± 12.5 years, and 673 (44%) patients were female.The mean CHADS2 and CHA2DS2-VASc scores were 1.76 and 3.08, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.

ABSTRACT

Background: Atrial fibrillation (AF) increases the risk of stroke and death. Data on the predictors for stroke and death in 'real-world' AF patients are limited, especially from large prospective Asian cohorts.

Methods: The Fushimi AF Registry is a community-based prospective survey designed to enroll all AF patients who visited the participating medical institutions in Fushimi-ku, Kyoto, Japan. Follow-up data were available for 3,304 patients (median follow-up period 741 days). We explored the predictors for 'death, stroke, and systemic embolism (SE)' during follow-up in 1,541 patients not receiving oral anticoagulants (OAC) at baseline.

Results: The mean age was 73.1 ± 12.5 years, and 673 (44%) patients were female. The mean CHADS2 and CHA2DS2-VASc scores were 1.76 and 3.08, respectively. Cumulative events were as follows: stroke/SE in 61 (4%) and death in 230 (15%), respectively. On multivariate analysis, advanced age (hazard ratio (HR): 1.68, 95% confidence interval (CI): 1.24-2.29), underweight (body mass index <18.5 kg/m2) (HR: 1.71, 95% CI: 1.25-2.32), previous stroke/SE/transient ischemic attack (HR: 1.70, 95% CI: 1.25-2.30), heart failure (HR: 1.59, 95% CI: 1.17-2.15), chronic kidney disease (HR: 1.53, 95% CI: 1.16-2.02), and anemia (HR: 2.41, 95% CI: 1.78-3.28) were independent predictors for death/stroke/SE. Cumulative numbers of these 6 risk predictors could stratify the incidence of death/stroke/SE in patients without OAC, as well as those with OAC in our registry.

Conclusions: Advanced age, underweight, previous stroke/SE/transient ischemic attack, heart failure, chronic kidney disease, and anemia were independently associated with the risk of death/stroke/SE in non-anticoagulated Japanese AF patients.

No MeSH data available.


Related in: MedlinePlus

(A) The number of patients for each cumulative number of risk factors in patients without oral anticoagulant (OAC). (B) Incidence of death/stroke/systemic embolism (SE) during follow-up for each cumulative number of risk factors in patients without OAC. (C) Kaplan-Meier curves for the incidence of events during follow-up in patients without OAC. Risk factors are the following 6 components; advanced age, underweight, previous stroke/SE/TIA, heart failure, CKD, and anemia.
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pone.0142394.g002: (A) The number of patients for each cumulative number of risk factors in patients without oral anticoagulant (OAC). (B) Incidence of death/stroke/systemic embolism (SE) during follow-up for each cumulative number of risk factors in patients without OAC. (C) Kaplan-Meier curves for the incidence of events during follow-up in patients without OAC. Risk factors are the following 6 components; advanced age, underweight, previous stroke/SE/TIA, heart failure, CKD, and anemia.

Mentions: Among the patients without OAC, the numbers of patients and the incidence of death/stroke/SE for each cumulative number of 6 risk factors (advanced age, underweight, previous stroke/SE/TIA, heart failure, CKD, and anemia) are shown in Fig 2A and 2B. Kaplan-Meier curves for the incidence of death/stroke/SE during follow-up between risk categories in patients without OAC are shown in Fig 2C. The cumulative number of these 6 risk factors show a significant gradient for the incidence of these endpoints.


Predictors for Stroke and Death in Non-Anticoagulated Asian Patients with Atrial Fibrillation: The Fushimi AF Registry.

Hamatani Y, Yamashita Y, Esato M, Chun YH, Tsuji H, Wada H, Hasegawa K, Abe M, Lip GY, Akao M - PLoS ONE (2015)

(A) The number of patients for each cumulative number of risk factors in patients without oral anticoagulant (OAC). (B) Incidence of death/stroke/systemic embolism (SE) during follow-up for each cumulative number of risk factors in patients without OAC. (C) Kaplan-Meier curves for the incidence of events during follow-up in patients without OAC. Risk factors are the following 6 components; advanced age, underweight, previous stroke/SE/TIA, heart failure, CKD, and anemia.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4634924&req=5

pone.0142394.g002: (A) The number of patients for each cumulative number of risk factors in patients without oral anticoagulant (OAC). (B) Incidence of death/stroke/systemic embolism (SE) during follow-up for each cumulative number of risk factors in patients without OAC. (C) Kaplan-Meier curves for the incidence of events during follow-up in patients without OAC. Risk factors are the following 6 components; advanced age, underweight, previous stroke/SE/TIA, heart failure, CKD, and anemia.
Mentions: Among the patients without OAC, the numbers of patients and the incidence of death/stroke/SE for each cumulative number of 6 risk factors (advanced age, underweight, previous stroke/SE/TIA, heart failure, CKD, and anemia) are shown in Fig 2A and 2B. Kaplan-Meier curves for the incidence of death/stroke/SE during follow-up between risk categories in patients without OAC are shown in Fig 2C. The cumulative number of these 6 risk factors show a significant gradient for the incidence of these endpoints.

Bottom Line: Follow-up data were available for 3,304 patients (median follow-up period 741 days).The mean age was 73.1 ± 12.5 years, and 673 (44%) patients were female.The mean CHADS2 and CHA2DS2-VASc scores were 1.76 and 3.08, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.

ABSTRACT

Background: Atrial fibrillation (AF) increases the risk of stroke and death. Data on the predictors for stroke and death in 'real-world' AF patients are limited, especially from large prospective Asian cohorts.

Methods: The Fushimi AF Registry is a community-based prospective survey designed to enroll all AF patients who visited the participating medical institutions in Fushimi-ku, Kyoto, Japan. Follow-up data were available for 3,304 patients (median follow-up period 741 days). We explored the predictors for 'death, stroke, and systemic embolism (SE)' during follow-up in 1,541 patients not receiving oral anticoagulants (OAC) at baseline.

Results: The mean age was 73.1 ± 12.5 years, and 673 (44%) patients were female. The mean CHADS2 and CHA2DS2-VASc scores were 1.76 and 3.08, respectively. Cumulative events were as follows: stroke/SE in 61 (4%) and death in 230 (15%), respectively. On multivariate analysis, advanced age (hazard ratio (HR): 1.68, 95% confidence interval (CI): 1.24-2.29), underweight (body mass index <18.5 kg/m2) (HR: 1.71, 95% CI: 1.25-2.32), previous stroke/SE/transient ischemic attack (HR: 1.70, 95% CI: 1.25-2.30), heart failure (HR: 1.59, 95% CI: 1.17-2.15), chronic kidney disease (HR: 1.53, 95% CI: 1.16-2.02), and anemia (HR: 2.41, 95% CI: 1.78-3.28) were independent predictors for death/stroke/SE. Cumulative numbers of these 6 risk predictors could stratify the incidence of death/stroke/SE in patients without OAC, as well as those with OAC in our registry.

Conclusions: Advanced age, underweight, previous stroke/SE/transient ischemic attack, heart failure, chronic kidney disease, and anemia were independently associated with the risk of death/stroke/SE in non-anticoagulated Japanese AF patients.

No MeSH data available.


Related in: MedlinePlus