A Novel Risk Stratification System for Ischemic Stroke in Japanese Patients With Non-Valvular Atrial Fibrillation

Background:Recently, identification of independent risk factors for ischemic stroke in Japanese non-valvular atrial fibrillation (NVAF) patients was made by analyzing the 5 major Japanese registries: J-RHYTHM Registry, Fushimi AF Registry, Shinken Database, Keio interhospital Cardiovascular Studies,...

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Veröffentlicht in:Circulation Journal 2021/07/21, Vol.85(8), pp.1254-1262
Hauptverfasser: Okumura, Ken, Tomita, Hirofumi, Nakai, Michikazu, Kodani, Eitaro, Akao, Masaharu, Suzuki, Shinya, Hayashi, Kenshi, Sawano, Mitsuaki, Goya, Masahiko, Yamashita, Takeshi, Fukuda, Keiichi, Ogawa, Hisashi, Tsuda, Toyonobu, Isobe, Mitsuaki, Toyoda, Kazunori, Miyamoto, Yoshihiro, Miyata, Hiroaki, Okamura, Tomonori, Sasahara, Yusuke, for the J-RISK AF Research Group
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Sprache:eng
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Zusammenfassung:Background:Recently, identification of independent risk factors for ischemic stroke in Japanese non-valvular atrial fibrillation (NVAF) patients was made by analyzing the 5 major Japanese registries: J-RHYTHM Registry, Fushimi AF Registry, Shinken Database, Keio interhospital Cardiovascular Studies, and the Hokuriku-Plus AF Registry.Methods and Results:The predictive value of the risk scheme in Japanese NVAF patients was assessed. Of 16,918 patients, 12,289 NVAF patients were analyzed (mean follow up, 649±181 days). Hazard ratios (HRs) of each significant, independent risk factor were determined by using adjusted Cox-hazard proportional analysis. Scoring system for ischemic stroke was created by transforming HR logarithmically and was estimated by c-statistic. During the 21,820 person-years follow up, 241 ischemic stroke events occurred. Significant risk factors were: being elderly (aged 75–84 years [E], HR=1.74), extreme elderly (≥85 years [EE], HR=2.41), having hypertension (H, HR=1.60), previous stroke (S, HR=2.75), type of AF (persistent/permanent) (T, HR=1.59), and low body mass index
ISSN:1346-9843
1347-4820
1347-4820
DOI:10.1253/circj.CJ-20-1075