Prevalence and Prognosis of Patients With Atrial Fibrillation in Japan

Suzuki, Shinya; Yamashita, Takeshi; Ohtsuka, Takayuki; Sagara, Koichi; Uejima, Tokuhisa; Oikawa, Yuji; Yajima, Junji; Koike, Atsushi; Nagashima, Kazuyuki; Kirigaya, Hajime; Ogasawara, Kunio; Sawada, Hitoshi; Aizawa, Tadanori

doi:10.1253/circj.72.914

Cited by 85 publications

(54 citation statements)

References 29 publications

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“…14 The study population comprised all the new patients who had visited our hospital, the Cardiovascular Institute, in Tokyo, between June 2004 and March 2007 and did not meet the exclusion criteria, including patients who already had confirmed diagnosis of cancer and had plans to receive treatments for it at the initial visits, patients living abroad, and patients visiting just one time without any examinations. Among the database population, all patients diagnosed as CAD and receiving blood tests at the initial visits were identified.…”

Section: Study Populationmentioning

confidence: 99%

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Impact of reduced renal function on prognosis in Japanese patients with coronary artery disease: a prospective cohort of Shinken Database 2007

et al. 2009

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Patients with coronary artery disease (CAD) frequently have impaired renal function, but the prevalence and influence of renal dysfunction on their prognosis in Japan remain uncertain. With a prospective study comprising all the new patients who had visited our hospital between 2004 and 2007 (n¼6562), we investigated the prevalence of renal dysfunction and its influence on the prognosis of CAD patients. The glomerular filtration rate (GFR) was calculated by using the GFR equation used for the Japanese population. Of those, 797 patients with CAD and blood tests available were analyzed (median follow-up periods of 693 days). Patients were further classified into four subgroups according to estimated GFR value (eGFR): normal (90peGFR, 12.2%), mildly impaired (60peGFRo90, 58.3%), moderately impaired (30peGFRo60, 23.6%) and severely impaired renal function (eGFRo30, 5.9%). The 2-year survival and cardiovascular event (cardiac death, nonfatal myocardial infarction or readmission for heart failure)-free rates were significantly different among the four subgroups: 98.9, 97.7, 89.3 vs. 67.8%, respectively (Po0.001 for trend), and 100, 98.8, 89.0 vs. 70.0%, respectively (Po0.001 for trend). The age-and gender-adjusted mortality increased significantly in moderately impaired (hazard ratio (HR) 3.1, 95% confidence interval (CI) 1.383-7.017) and in severely impaired subgroups (HR 10.1, 95% CI 4.244-24.178) compared with those with eGFR of 60 or more. After adjustment for baseline differences, eGFR was independently associated with death and cardiovascular events (HR 0.983 and 0.981, 95% CI 0.968-0.998 and 0.965-0.998, respectively). In conclusion, our study identified the prevalence and association of eGFR with prognosis in Japanese patients with CAD, suggesting that strict care for not only CAD but also renal dysfunction is needed for further prevention of cardiovascular events.

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Section: Study Populationmentioning

confidence: 99%

“…14 In this study with this database, we evaluated the distribution of an eGFR value and long-term prognosis in Japanese patients with CAD according to the eGFR value.…”

Section: Introductionmentioning

confidence: 99%

Impact of reduced renal function on prognosis in Japanese patients with coronary artery disease: a prospective cohort of Shinken Database 2007

et al. 2009

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“…According to a report from a single medical facility in Japan, 12) the annual rate of cardiovascular death among AF patients was 1.3% per year and did not differ significantly between the paroxysmal AF group and persistent AF group. A similar result was also obtained in the present study, in which the incidence of cardiovascular death was 1.0-1.2% per year in both the first detected AF group and non-first detected AF group.…”

Section: Discussionmentioning

confidence: 98%

“…5) Epidemiological reports on the mortality rate and prevalence of AF have been made in several retrospective surveys in general populations and general practices in western countries, [6][7][8][9][10] but few reports based on clinical practice have been published by Japanese facilities providing cardiovascular management. 11,12) The ACC/AHA/ESC Guidelines state that antiarrhythmic drug therapy (rhythm control) is not indicated for first detected AF unless the patient shows significant signs of hypotension, heart failure, or angina pectoris. 13) During clinical practice, however, it is not uncommon that first detected AF causes severe subjective symptoms and a deteriorating quality of life (QOL).…”

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confidence: 99%

Clinical Profiles, Efficacy of Antiarrhythmic Drug Therapy, and Cardiovascular Prognosis in Patients With First Detected Paroxysmal Atrial Fibrillation

et al. 2011

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SummaryLittle information is available concerning clinical profiles and outcomes of treatment in Japanese patients with first detected atrial fibrillation (AF). In the present study, 459 patients with paroxysmal AF (309 males, mean age, 66 ± 12 years) were divided into a first detected AF group (group A, n = 143) and a non-first detected AF group (group B, n = 316). Clinical profiles, prophylactic efficacy of antiarrhythmic drug therapy (AAD), and cardiovascular prognosis during a mean follow-up period of 50 ± 35 months were compared between the two groups. The number of AF recurrences in the individual patients regardless of AAD were significantly lower in group A than in group B (0.8 ± 1.4 versus 1.7 ± 1.9) (P < 0.05). The percentages of patients free from conversion to chronic AF at 12, 36, 60, and 120 months were significantly higher in group A (98%, 96%, 93%, and 91%, respectively) than in group B (95%, 86%, 83%, and 79%, respectively)(P < 0.01). The annual rates of hospitalization for thromboembolism, heart failure, and cardiovascular death did not differ between group A (2.2%, 1.1% and 1.0%, respectively) and group B (2.2%, 1.9% and 1.1%, respectively). In multivariate logistic regression analysis, a CHADS 2 score ≥ 2 points (odds ratio 13.1, 95% confidence interval 3.36-51.0, P = 0.001), nocturnal AF onset (OR 0.201, 95% CI 0.050-0.815, P = 0.025), left ventricular diastolic dimension (LVDd) ≥ 50 mm (OR 3.845, 95% CI 1.078-13.71, P = 0.038), and conversion to chronic AF (OR 3.547, 95% CI 1.002-13.64, P = 0.048) were associated with cardiovascular events in group A. Rhythm control therapy with antiarrhythmic drugs was shown to be more effective for patients in group A than in group B. It is particularly important to prevent cardiovascular events in first detected AF patients with a CHADS 2 score ≥ 2 points, LVDd ≥ 50 mm, and conversion to chronic AF. (Int Heart J 2011; 52: 32-38)

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“…We retrospectively analyzed TTE and TEE data plus clinical information of 190 consecutive patients with nonvalvular paroxysmal AF (NVAF) enrolled in the Shinken Database, which contains data on all new patients visiting the Cardiovascular Institute Hospital in Tokyo between November 2009 and March 2014; details on this database have been published elsewhere. 16,17) All clinical and echocardiographic data were obtained within 3 months following the first visit to our hospital. The indication for TEE was based on either an evaluation of potential thromboembolic risk or identification of stroke secondary to confirmed cardiogenic embolism.…”

Section: Methodsmentioning

confidence: 99%

Left Atrial Remodeling Assessed by Transthoracic Echocardiography Predicts Left Atrial Appendage Flow Velocity in Patients With Paroxysmal Atrial Fibrillation

et al. 2016

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SummaryAtrial fibrillation (AF) is associated with an increased risk of stroke and other thromboembolic events. Left atrial (LA) thrombus formation is closely related to LA dysfunction, particularly to decreased LA appendage flow velocity (LAA-FV) in patients with AF. We estimated LAA-FV using parameters noninvasively obtained by transthoracic echocardiography (TTE) in patients with paroxysmal AF.Echocardiographic and clinical parameters were assessed in 190 patients with nonvalvular paroxysmal AF showing sinus heart rhythm during transesophageal echocardiography (TEE) and TTE.LAA-FV (60 ± 22 cm/s) significantly correlated with the time interval between the initiation of the P-wave on ECG and that of the A-wave of transmitral flow on TTE (PA-TMF, correlation coefficient, −0.32; P < 0.001), LA dimension (LAD, −0.31; P < 0.001), septal a' velocity of tissue Doppler imaging (TDI, 0.35; P < 0.001), E/e' ratio (−0.28, P < 0.001), E velocity of transmitral flow (−0.20, P = 0.008), E/A ratio of transmitral flow (−0.18, P = 0.02), CHA2DS2-VASc score (−0.15, P = 0.04), and BNP plasma level (−0.32, P = 0.002). Multivariate analysis revealed that PA-TMF (standardized partial regression coefficient, −0.17; P = 0.03), a' velocity (0.24, P = 0.004), and LAD (−0.20, P = 0.01) were independent predictors of LAA-FV (multiple correlation coefficient R, 0.44; P < 0.001).Parameters of atrial remodeling, ie, decreased a' velocity, increased LAD, and PA-TMF during sinus rhythm may be useful predictors of LA blood stasis in patients with nonvalvular PAF. LAA-FV can be estimated using these TTE parameters instead of TEE. (Int Heart J 2016; 57: 177-182)

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Prevalence and Prognosis of Patients With Atrial Fibrillation in Japan

Cited by 85 publications

References 29 publications

Impact of reduced renal function on prognosis in Japanese patients with coronary artery disease: a prospective cohort of Shinken Database 2007

Impact of reduced renal function on prognosis in Japanese patients with coronary artery disease: a prospective cohort of Shinken Database 2007

Clinical Profiles, Efficacy of Antiarrhythmic Drug Therapy, and Cardiovascular Prognosis in Patients With First Detected Paroxysmal Atrial Fibrillation

Left Atrial Remodeling Assessed by Transthoracic Echocardiography Predicts Left Atrial Appendage Flow Velocity in Patients With Paroxysmal Atrial Fibrillation

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