Prevalence and Clinical Characteristics of Patients With Atrial Fibrillation

Tomita, Fumishi; Kohya, Tetsuro; Sakurai, Minoru; Kaji, Tomohito; Yokoshiki, Hisashi; Sato, Minoru; Sasaki, Kohji; Itoh, Yoshinori; Konno, Masashi; Kitabatake, Akira

doi:10.1253/jcj.64.653

Cited by 76 publications

(42 citation statements)

References 20 publications

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“…7) However, the mean age of our patients was about 5 years older than theirs. Age is one of the most important risk factors for stroke, because the prevalence of other risk factors generally increases with age.…”

Section: Discussioncontrasting

confidence: 50%

Effectiveness of Risk Stratification According to CHADS2 Score in Japanese Patients With Nonvalvular Atrial Fibrillation

et al. 2009

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SummaryCerebrovascular events increase with additional risk factors in patients with nonvalvular atrial fibrillation (NVAF). The relative risk proportional to the number of risk factors in Japanese patients has not been reported.The prevalence of risk factors was investigated for over 2 years in a prospective cohort study of 265 patients with NVAF. The CHADS2 score is a widely used risk stratification scheme that includes age, hypertension, diabetes mellitus, previous stroke, and heart failure.Cerebral infarction occurred in 23 patients. This group was significantly older and had a significantly higher prevalence of hypertension. The ratio of a CHADS2 score of 0 -2 was 77% among patients without stroke, but 44% in the cerebral infarction group. Univariate logistic regression analysis showed that the predictive factors of cerebral infarction were: age (odds ratio (OR) 1.087 (confidence interval (CI) 1.032 -1.145, P = 0.002), hypertension (OR 3.288 (CI 1.086 -9.962, P = 0.03) and CHADS2 score (OR 1.762 (CI 1.222 -2.543, P = 0.002). Furthermore, a CHADS2 score of 3 -6 was associated with a greater risk of cerebral infarction (OR 4.420 (CI 1.838 -10.631, P < 0.001).The CHADS2 score was a useful marker of stroke risk in this Japanese population. An increased CHADS2 score was associated with an approximate 1.8-fold increase in risk. (Int Heart J 2009; 50: 323-329)

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Section: Discussioncontrasting

confidence: 50%

Effectiveness of Risk Stratification According to CHADS2 Score in Japanese Patients With Nonvalvular Atrial Fibrillation

et al. 2009

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“…[13][14][15][16][17][18] Meta-analysis on an intention-to-treat basis has confirmed that the risk of ischemic stroke is 61% lower in patients treated with anticoagulant therapy than in those treated with placebo therapy. 19) Epidemiological studies performed in Japan have shown that the annual rate of ischemic stroke in nonvalvular AF patients is 2.8-4.5%, 20,21) which is similar to that in Western studies. However, the observation period was relatively short (approximately 1-2 years) in these studies, and there have been few long-term investigations like the present study in which observation was continued for approximately 5 years.…”

Section: Discussionsupporting

confidence: 60%

Relationship Between CHADS2 Score and Ischemic Stroke During Rhythm Control Therapy for Paroxysmal Atrial Fibrillation

et al. 2010

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SummaryThe CHADS 2 score has been proposed for stratifying patients with nonvalvular atrial fibrillation (NVAF) according to the risk of thromboembolism in the AHA/ACC/ESC guidelines. However, there is little information about its usefulness for predicting the long-term risk of ischemic stroke in Japanese patients with paroxysmal AF. We retrospectively evaluated the incidence of ischemic stroke and the efficacy of anticoagulant therapy in paroxysmal AF patients on rhythm control therapy who were stratified by their CHADS 2 score. The subjects were 334 NVAF patients (229 men and 105 women, mean age, 68 ± 12 years, mean follow-up period, 60 ± 35 months) who were categorized into low risk (score 0), moderate risk (1 or 2), and high risk (3 or more) groups for thromboembolism.The low, moderate, and high risk groups accounted for 34%, 50%, and 16% of the patients, respectively. Among 257 patients without warfarin therapy, the annual rate of symptomatic ischemic stroke was 0.6% in the score 0 group, 0.5% in the score 1 group, 3.1% in the score 2 group, and 9.6% in the score 3 or more group. Among 77 patients treated with warfarin (target PT-INR: 1.6-3.0), the stroke rate was 0% in the score 0 group, 0% in the score 1 group, 1.4% in the score 2 group, and 6.6% in the score 3 or more group. The annual rate of ischemic stroke was 0.88% in patients treated with warfarin versus 2.67% in those without warfarin, or a decrease in risk of 68% with warfarin (P < 0.01). In Japanese patients with paroxysmal AF, the CHADS 2 score is useful for predicting the risk of ischemic stroke. Anticoagulant therapy is needed to prevent ischemic stroke in patients with paroxysmal AF, especially those who have a CHADS 2 score of 2 or more. (Int Heart J 2010; 51: 24-29)Key words: Paroxysmal atrial fibrillation, Thromboembolism, Anticoagulant therapy, Antiarrhythmic therapy, CHADS 2 score A ccording to the results of epidemiological studies in Western countries, the incidence of atrial fibrillation (AF) is approximately 4% and 10% among persons in their seventies and eighties, respectively, showing a marked increase with age. 1) In Japan, the proportion of elderly in the population is increasing rapidly, and the incidence of AF has increased markedly compared with that in the 1980s to approximately 2% and 3.2% among persons in their seventies and eighties, respectively, although it is still less than half of the incidence reported in Western countries.2) Since the incidence of AF will continue to increase in the future, AF is recognized as a significant medical and social problem.AF is often encountered in routine medical practice and is an arrhythmia that should be actively treated and controlled, because it not only causes cardiovascular complications, including thromboembolism and heart failure, 3) but also decreases the survival of patients with impaired left ventricular function. 4) In Western countries, to prevent ischemic stroke as a serious complication of nonvalvular AF, risk stratification is performed based on the CHADS 2 score and an...

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“…In a hospital-based study, the prevalence of AF among outpatients was 14%. 7 In a population-based study, it was found that the prevalence of AF in a mixed group of men and women increased from 0.2% in persons aged 40 to 59 years to 2.5% in persons 80 years or older. 8 The results of our study are similar to those of that study.…”

Section: Women Both Sexesmentioning

confidence: 99%

Rapid Increase in Estimated Number of Persons with Atrial Fibrillation in Japan: An Analysis from National Surveys on Cardiovascular Diseases in 1980, 1990 and 2000

Ohsawa

Okayama

Sakata

et al. 2005

Journal of Epidemiology

123

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Prevalence and Clinical Characteristics of Patients With Atrial Fibrillation

Cited by 76 publications

References 20 publications

Effectiveness of Risk Stratification According to CHADS2 Score in Japanese Patients With Nonvalvular Atrial Fibrillation

Effectiveness of Risk Stratification According to CHADS2 Score in Japanese Patients With Nonvalvular Atrial Fibrillation

Relationship Between CHADS2 Score and Ischemic Stroke During Rhythm Control Therapy for Paroxysmal Atrial Fibrillation

Rapid Increase in Estimated Number of Persons with Atrial Fibrillation in Japan: An Analysis from National Surveys on Cardiovascular Diseases in 1980, 1990 and 2000

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