Prognostic Impact of Atrial Fibrillation and New Risk Score of Its Onset in Patients at High Risk of Heart Failure　― A Report From the CHART-2 Study ―

Yamauchi, Takeshi; Sakata, Yasuhiko; Miura, Masanobu; Onose, Takeo; Tsuji, Kiichiro; Abe, Ruri; Oikawa, Takuya; Kasahara, Satoshi; Sato, Masayuki; Nochioka, Kotaro; Shiroto, Takashi; Takahashi, Jun; Miyata, Satoshi; Shimokawa, Hiroaki

doi:10.1253/circj.cj-16-0759

Cited by 23 publications

(22 citation statements)

References 51 publications

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“…Aging is an important factor that is related to global DNA hypomethylation and promoter hypermethylation. AF is an age‐related disease; previous study shows that AF patients have a higher age compared with non‐AF patients . The difference in age in the 2 groups in our results correlated with this study (AF patients are older compared with SR patients).…”

Section: Discussionsupporting

confidence: 90%

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DNA methylation dysregulations in valvular atrial fibrillation

Shen

Yuan

et al. 2017

Clinical Cardiology

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Background The epigenetic changes underlying the development of atrial fibrillation (AF) remain incompletely understood. Limited evidence suggests that abnormal DNA methylation might be involved in the pathogenesis of AF. In the present study, we evaluated the methylation status of genomic DNA from myocardial tissue in AF patients and sinus rhythm (SR) patients systematically. Hypothesis DNA methylation dysregulations will be associated with valvular AF. Methods Right atrial myocardial tissue was obtained from rheumatic valvular patients who had undergone valve replacement surgery (SR group, n = 10; AF group, n = 10). The global DNA methylation level, the promoter methylation level of the natriuretic peptide receptor‐A gene (NPRA), and its correlation with the mRNA expression level of DNA methyltransferase genes were detected. Results The global DNA methylation level was significantly higher in the AF group than in the SR group (P < 0.05). The NPRA mRNA expression was decreased and the NPRA gene was hypermethylated in the AF group (P < 0.05). Meanwhile, the NPRA mRNA expression level has a negative correlation with the mean methylation level in the promoter region of the NPRA gene. Conclusions DNA methylation dysregulations may be relevant in the pathogenesis of AF. DNA methyltransferase 3B likely plays an essential role in the DNA methylation dysregulations in AF.

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Section: Discussionsupporting

confidence: 90%

“…AF is an age-related disease; previous study shows that AF patients have a higher age compared with non-AF patients. 24 The difference in age in the 2 groups in our results correlated with this study (AF patients are older compared with SR patients). Our results showed that global DNA methylation levels had a positive correlation with age.…”

Section: Discussionsupporting

confidence: 90%

DNA methylation dysregulations in valvular atrial fibrillation

Shen

Yuan

et al. 2017

Clinical Cardiology

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“…CHART‐2 data that support the findings of this study are available from the corresponding author on reasonable request. The CHART‐2 study has been described in detail previously . Briefly, CHART‐2 (n=10219) is a multicenter, prospective, observational cohort study designed to identify the characteristics, mortality, and prognostic risks of patients with a history of HF and those without HF but at high risk of HF in Japan .…”

Section: Methodsmentioning

confidence: 99%

“…The CHART‐2 study has been described in detail previously . Briefly, CHART‐2 (n=10219) is a multicenter, prospective, observational cohort study designed to identify the characteristics, mortality, and prognostic risks of patients with a history of HF and those without HF but at high risk of HF in Japan . From October 2006 to March 2010, 10219 consecutive stable patients at outpatient clinics or just before discharge aged >20 years were successfully enrolled in CHART‐2 if they had stage B, C, or D HF or significant coronary artery disease in stage A, as defined according to the ACC/AHA guidelines .…”

Section: Methodsmentioning

confidence: 99%

“…In contrast to the ACC/AHA guidelines, the European Society of Cardiology and European Atherosclerosis Society guidelines and the Japanese Circulation Society guidelines recommend treatments targeting LDL‐C levels for secondary prevention of ASCVD . In the present study, we examined the prognostic impact of statin use in ischemic HF patients, with special reference to statin intensity and LDL‐C levels, using our database for the CHART‐2 (Chronic Heart Failure Registry and Analysis in the Tohoku District 2) study …”

Section: Introductionmentioning

confidence: 99%

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Prognostic Impact of Statin Intensity in Heart Failure Patients With Ischemic Heart Disease: A Report From the CHART‐2 (Chronic Heart Failure Registry and Analysis in the Tohoku District 2) Study

Oikawa

Sakata

Nochioka

et al. 2018

JAHA

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BackgroundThe beneficial prognostic impact of statins has been established in patients with ischemic heart disease but not in those with heart failure (HF). In addition, it is still unclear whether patients benefit from statins regardless of low‐density lipoprotein cholesterol levels.Methods and ResultsWe examined 2444 consecutive stage C or D HF patients with ischemic heart disease registered in CHART‐2 (Chronic Heart Failure Registry and Analysis in the Tohoku District 2), a multicenter, prospective, observational cohort study in Japan. Patients were divided into 3 groups according to the Japanese standard doses of statins and statin‐intensity categories defined by the 2013 American College of Cardiology and American Heart Association guidelines: higher (moderate‐high)‐intensity (n=868), lower (low)‐intensity (n=526), and no statin (n=1050). The median follow‐up period was 6.4 years (13929 person‐years). Analysis with the inverse probability of treatment weighted using a propensity score for multiple treatment revealed that both the higher‐intesity group (hazard ratio [HR]: 0.68; P<0.001) and the lower‐intensity group (HR: 0.82; P<0.001) had significantly lower incidence of the primary end point—a composite of all‐cause death and HF admission—compared with the no statin group. The higher‐intensity statin group had significantly lower incidence of the primary end point (HR: 0.82; P<0.001), all‐cause death (HR: 0.83; P<0.001), and HF admission (HR: 0.78; P<0.001) than the lower‐intensity statin group. Moreover, the use of statins, either higher‐ or lower‐intensity, was associated with reduced incidence of the primary end point, regardless of low‐density lipoprotein cholesterol levels.ConclusionsThese results suggest that statin use, particularly the use of higher‐intensity statins, has a beneficial prognostic impact in HF patients with ischemic heart disease, regardless of low‐density lipoprotein cholesterol levels.Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00418041.

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H₂FPEF score for predicting future heart failure in stable outpatients with cardiovascular risk factors

et al. 2020

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Aims The prediction of future heart failure (HF) in stable outpatients is often difficult for general practitioners and cardiologists. Recently, the H2FPEF score (0–9 points) has been proposed for the discrimination of HF with preserved ejection fraction from non‐cardiac causes of dyspnoea. The six clinical and echocardiographic variables that constitute the H2FPEF score include the following: (i) obesity (H); (ii) the use of ≥2 antihypertensive drugs (H); (iii) atrial fibrillation (F); (iv) pulmonary hypertension (P); (v) an age > 60 years (E); and (vi) E/e' > 9 (F). We performed an external validation study that investigated whether the H2FPEF score could predict future HF‐related events in stable outpatients with cardiovascular risk factor(s) in Japan. Methods and results In this prospective cohort study, after exclusion of 195 from 551 consecutive, stable Japanese outpatients with at least one cardiovascular risk factor who were enrolled between September 2010 and July 2013, the remaining 356 outpatients (171 men, 185 women, mean age 73.2 years) were eligible for the analysis. We calculated the H2FPEF score (0–9 points), and followed up the patients for an average of 517 days. In all of the 356 patients, the mean H2FPEF score was 3.1 ± 1.8, and 15 developed HF‐related events during the follow‐up period, including cardiovascular death (n = 2) and hospitalization for HF decompensation (n = 13). Multivariate Cox proportional hazards analysis showed that the H2FPEF score was an independent predictor of future HF‐related events (P < 0.001 for all three models). Kaplan–Meier survival curves showed a significantly higher probability of HF‐related events in the outpatients with a high H2FPEF score (P < 0.001). In receiver operating characteristic (ROC) curve analysis, the H2FPEF score was significantly associated with the occurrence of future HF‐related events (P < 0.001). In ROC curve analysis, the sensitivity, specificity, and positive likelihood ratio of a H2FPEF score of 7 points to predict HF‐related events were 47%, 96%, and 11.4%, respectively. Conclusions The H2FPEF score could provide useful information for future HF‐related events in stable outpatients with cardiovascular risk factor(s) in Japan.

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Prognostic Impact of Atrial Fibrillation and New Risk Score of Its Onset in Patients at High Risk of Heart Failure　― A Report From the CHART-2 Study ―

Cited by 23 publications

References 51 publications

DNA methylation dysregulations in valvular atrial fibrillation

DNA methylation dysregulations in valvular atrial fibrillation

Prognostic Impact of Statin Intensity in Heart Failure Patients With Ischemic Heart Disease: A Report From the CHART‐2 (Chronic Heart Failure Registry and Analysis in the Tohoku District 2) Study

H₂FPEF score for predicting future heart failure in stable outpatients with cardiovascular risk factors

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Prognostic Impact of Atrial Fibrillation and New Risk Score of Its Onset in Patients at High Risk of Heart Failure ― A Report From the CHART-2 Study ―

Cited by 23 publications

References 51 publications

DNA methylation dysregulations in valvular atrial fibrillation

DNA methylation dysregulations in valvular atrial fibrillation

Prognostic Impact of Statin Intensity in Heart Failure Patients With Ischemic Heart Disease: A Report From the CHART‐2 (Chronic Heart Failure Registry and Analysis in the Tohoku District 2) Study

H2FPEF score for predicting future heart failure in stable outpatients with cardiovascular risk factors

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Product

Resources

About

Prognostic Impact of Atrial Fibrillation and New Risk Score of Its Onset in Patients at High Risk of Heart Failure　― A Report From the CHART-2 Study ―

H₂FPEF score for predicting future heart failure in stable outpatients with cardiovascular risk factors