Beneficial Effect of Non-Vitamin K Antagonist Oral Anticoagulants in Patients With Nonvalvular Atrial Fibrillation　– Results of the J-RHYTHM Registry 2 –

• Kodani Eitaro

  Department of Internal Medicine and Cardiology, Nippon Medical School, Tama-Nagayama Hospital

• Atarashi Hirotsugu

  Department of Internal Medicine and Cardiology, Nippon Medical School, Tama-Nagayama Hospital

• Inoue Hiroshi

  Saiseikai Toyama Hospital

• Okumura Ken

  Department of Cardiology, Respiratory Medicine and Nephrology, Hirosaki University Graduate School of Medicine

• Yamashita Takeshi

  The Cardiovascular Institute

• Origasa Hideki

  Division of Biostatistics and Clinical Epidemiology, University of Toyama

• on behalf of the J-RHYTHM Registry Investigators

Bibliographic Information

Other Title

• LATE BREAKING COHORT STUDY (JCS 2016) : Beneficial Effect of Non-Vitamin K Antagonist Oral Anticoagulants in Patients With Nonvalvular Atrial Fibrillation : Results of the J-RHYTHM Registry 2
• Beneficial effect of non-vitamin K antagonist oral anticoagulants in patients with nonvalvular atrial fibrillation—results of the J-RHYTHM Registry 2

Abstract

Background:The J-RHYTHM Registry 2 was a multicenter, prospective observational study that extended the follow-up period of the J-RHYTHM Registry in order to investigate long-term outcomes and effects of non-vitamin K antagonist oral anticoagulants (NOACs) in Japanese patients with atrial fibrillation (AF).Methods and Results:Among 6,616 patients with nonvalvular AF (NVAF) (men 71.0%, 69.7±9.9 years, CHADS₂score 1.7±1.2), event rates were compared among patients receiving warfarin (n=3,964), NOACs (n=923), and no anticoagulation therapy (No-OAC, n=753) at the end of follow-up, except for 976 patients lacking anticoagulant data. During the 5-year follow-up period, thromboembolism occurred in 196 (4.9%), 19 (2.1%), and 45 (6.0%) patients, respectively; major hemorrhage in 233 (5.9%), 22 (2.4%), and 36 (4.8%); all-cause death in 230 (5.8%), 13 (1.4%), and 105 (13.9%), (P<0.001 for each). After adjusting for the components of the CHA₂DS₂-VASc score and antiplatelet drug use, the odds ratio (OR) in the Warfarin group was significantly lower for all-cause death compared with that in the No-OAC group (OR 0.30, 95% confidence interval [CI] 0.23–0.39, P<0.001), whereas ORs in the NOACs group were significantly lower for all events (OR 0.42, 95% CI 0.24–0.74, P=0.003 for thromboembolism; OR 0.53, 95% CI 0.31–0.93, P=0.027 for major hemorrhage; and OR 0.10, 95% CI 0.06–0.18, P<0.001 for all-cause death, respectively).Conclusions:NOACs could be beneficial for reducing event rates of all types in Japanese NVAF patients. (Circ J 2016; 80: 843–851)

Journal

• Circulation Journal

  Circulation Journal 80 (4), 843-851, 2016

  The Japanese Circulation Society

Keywords

• Anticoagulation
• Atrial fibrillation
• J-RHYTHM Registry
• Non-vitamin K antagonist oral anticoagulants (NOACs)
• Warfarin

Details

• CRID: 1390001205109027712
• NII Article ID: 130005139549
• NII Book ID: AA11591968
• DOI: 10.1253/circj.cj-16-0066
• ISSN: 13474820
• ISSN: 13469843
• NDL BIB ID: 027202877
• PubMed: 27001190
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I027202877
• Web Site: https://www.jstage.jst.go.jp/article/circj/80/4/80_CJ-16-0066/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2016250696
• Text Lang: en
• Data Source:
  • JaLC
  • NDL
  • Crossref
  • PubMed
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed