Regional Differences in Frequency of Warfarin Therapy and Thromboembolism in Japanese Patients With Non-Valvular Atrial Fibrillation　– Analysis of the J-RHYTHM Registry –

Abstract

on behalf of the J-RHYTHM Registry Investigators 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).

Analysis of geographical variations in the epidemiology and management of non-valvular atrial fibrillation: results from the RAMSES registry

“…In a previous study investigating warfarin use in patients with AF in the USA, the lowest frequency of warfarin use was noted in the southern part of the USA ( 17 ). Similarly, regional differences in the frequency of warfarin use were statistically significant in Japan, with the lowest use seen in Hokkaido, followed by Shikoku ( 18 ). Baseline INR and TTR also significantly differed between the regions in Japan ( 18 ).…”

“…Similarly, regional differences in the frequency of warfarin use were statistically significant in Japan, with the lowest use seen in Hokkaido, followed by Shikoku ( 18 ). Baseline INR and TTR also significantly differed between the regions in Japan ( 18 ). However, there is limited knowledge on the regional differences in frequency of warfarin or NOAC use or guideline adherence of management among patients with NVAF in Turkey.…”

“…The results of the ADHERE-International and Realise AF studies have shown that the proportion of patients with AF treated with OAC therapy varies between different countries, and the intensity and quality of warfarin-based anticoagulant therapy also differs between geographical regions around the world. Moreover, regional differences were detected in the proportions of patients with AF treated with warfarin for the prevention of thromboembolism in the USA and Japan ( 17 , 18 ).…”

Risk Profile and 1-Year Outcome of Newly Diagnosed Atrial Fibrillation in Japan ― Insights From GARFIELD-AF ―

“…Although the overall 1-year risk of stroke was slightly lower in Japan compared with the global average, these data indicate that there is still room for improvement in the use of AC for stroke prevention in Japan. 19 Compared with the average in all other countries in the GARFIELD-AF, patients from Japan had a lower risk of bleed. There are a few potential reasons for this.…”

“…18 In another study of >7,400 patients from 10 regions in Japan, mean INR and TTR were 1.9 and 60%, respectively. 19 The use of AP only rapidly decreased from 12.6% to 4.9% between the first (2010) and last year of recruitment (2016), which suggests good concordance with the 2013 JCS guidelines, which no longer recommend AP for stroke prevention.…”