Current status and clinical outcomes of oral anticoagulant discontinuation after ablation for atrial fibrillation in Japan ― findings from the AF Frontier Ablation Registry ―

Yasuo Okumura, Koichi Nagashima, Masaru Arai, Ryuta Watanabe, Katsuaki Yokoyama, Naoya Matsumoto, Takayuki Otsuka, Shinya Suzuki, Akio Hirata, Masato Murakami, Mitsuru Takami, Masaomi Kimura, Hidehira Fukaya, Shiro Nakahara, Takeshi Kato, Wataru Shimizu, Yu ki Iwasaki, Hiroshi Hayashi, Tomoo Harada, Ikutaro NakajimaKen Okumura, Junjiroh Koyama, Michifumi Tokuda, Teiichi Yamane, Yukihiko Momiyama, Kojiro Tanimoto, Kyoko Soejima, Noriko Nonoguchi, Koichiro Ejima, Nobuhisa Hagiwara, Masahide Harada, Kazumasa Sonoda, Masaru Inoue, Koji Kumagai, Hidemori Hayashi, Kazuhiro Satomi, Yoshinao Yazaki, Yuji Watari

研究成果: Article査読

3 被引用数 (Scopus)

抄録

Background: The safety of discontinuing oral anticoagulant (OAC) after ablation for atrial fibrillation (AF) in Japanese patients has not been clarified. Methods and Results: A study based on the Atrial Fibrillation registry to Follow the long-teRm Outcomes and use of aNTIcoagulants aftER Ablation (AF Frontier Ablation Registry) was conducted. Data were collected from 3,451 consecutive patients (74.1% men; age, 63.3±10.3 years) who had undergone AF ablation at any of 24 cardiovascular centers in Japan between August 2011 and July 2017. During a 20.7-month follow-up period, OAC therapy was discontinued in 1,836 (53.2%) patients; 51 patients (1.5%) suffered a stroke/ transient ischemic attack (TIA), 71 (2.1%) suffered major bleeding, and 36 (1.0%) died. Patients in whom OAC therapy was discontinued were significantly younger than those in whom OACs were continued, and their CHA2DS2-VASc scores were significantly lower. The incidences of stroke/TIA, major bleeding, and death were significantly lower among these patients. Upon multivariate adjustment, stroke events were independently associated with relatively high baseline CHA2DS2-VASc scores but not with OAC status. Conclusions: Although the incidences of stroke/TIA, major bleeding, and death were relatively low among patients for whom OAC therapy was discontinued, stroke/TIA occurrence was strongly associated with a high baseline stroke risk rather than with OAC status. Thus, discontinuation of OAC therapy requires careful consideration, especially in patients with a high baseline stroke risk.

本文言語English
ページ(範囲)2418-2427
ページ数10
ジャーナルCirculation Journal
83
12
DOI
出版ステータスPublished - 2019
外部発表はい

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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