Regional differences in frequency of warfarin therapy and thromboembolism in Japanese patients with non-valvular atrial fibrillation-analysis of the J-rhythm registry –

J-RHYTHM Registry Investigators

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

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 CHADS2 score, were detected among the regions. The highest mean CHADS2 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.

Original languageEnglish
Pages (from-to)1548-1555
Number of pages8
JournalCirculation Journal
Volume80
Issue number7
DOIs
Publication statusPublished - 01-01-2016

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Thromboembolism
Warfarin
Atrial Fibrillation
Registries
Japan
International Normalized Ratio
Prothrombin Time
Therapeutics
Population Density
Comorbidity
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Regional differences in frequency of warfarin therapy and thromboembolism in Japanese patients with non-valvular atrial fibrillation-analysis of the J-rhythm registry –",
abstract = "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 CHADS2 score, were detected among the regions. The highest mean CHADS2 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.",
author = "{J-RHYTHM Registry Investigators} and Hiroshi Inoue and Hirotsugu Atarashi and Eitaro Kodani and Ken Okumura and Takeshi Yamashita and Hideki Origasa and Masayuki Sakurai and Yuichiro Kawamura and Isao Kubota and Kazuo Matsumoto and Yoshiaki Kaneko and Satoshi Ogawa and Yoshifusa Aizawa and Masaomi Chinushi and Itsuo Kodama and Eiichi Watanabe and Yukihiro Koretsune and Yuji Okuyama and Akihiko Shimizu and Osamu Igawa and Shigenobu Bando and Masahiko Fukatani and Tetsunori Saikawa and Akiko Chishaki",
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Regional differences in frequency of warfarin therapy and thromboembolism in Japanese patients with non-valvular atrial fibrillation-analysis of the J-rhythm registry –. / J-RHYTHM Registry Investigators.

In: Circulation Journal, Vol. 80, No. 7, 01.01.2016, p. 1548-1555.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Regional differences in frequency of warfarin therapy and thromboembolism in Japanese patients with non-valvular atrial fibrillation-analysis of the J-rhythm registry –

AU - J-RHYTHM Registry Investigators

AU - Inoue, Hiroshi

AU - Atarashi, Hirotsugu

AU - Kodani, Eitaro

AU - Okumura, Ken

AU - Yamashita, Takeshi

AU - Origasa, Hideki

AU - Sakurai, Masayuki

AU - Kawamura, Yuichiro

AU - Kubota, Isao

AU - Matsumoto, Kazuo

AU - Kaneko, Yoshiaki

AU - Ogawa, Satoshi

AU - Aizawa, Yoshifusa

AU - Chinushi, Masaomi

AU - Kodama, Itsuo

AU - Watanabe, Eiichi

AU - Koretsune, Yukihiro

AU - Okuyama, Yuji

AU - Shimizu, Akihiko

AU - Igawa, Osamu

AU - Bando, Shigenobu

AU - Fukatani, Masahiko

AU - Saikawa, Tetsunori

AU - Chishaki, Akiko

PY - 2016/1/1

Y1 - 2016/1/1

N2 - 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 CHADS2 score, were detected among the regions. The highest mean CHADS2 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.

AB - 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 CHADS2 score, were detected among the regions. The highest mean CHADS2 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.

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