Relationship between the Renal Function and Adverse Clinical Events in Patients with Atrial Fibrillation: A Japanese Multicenter Registry Substudy
Atrial fibrillation (AF) and chronic kidney disease (CKD) often coexist, but the real-world data after approval of direct oral anticoagulants (DOACs) are still lacking in Japan. We investigated the association of the baseline renal function and adverse clinical events and risk of adverse clinical ev...
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| Veröffentlicht in: | Journal of clinical medicine 2020-01, Vol.9 (1), p.167 |
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| creator | Yuzawa, Yasuhumi Kuronuma, Keiichiro Okumura, Yasuo Yokoyama, Katsuaki Matsumoto, Naoya Tachibana, Eizo Oiwa, Koji Matsumoto, Michiaki Kojima, Toshiaki Haruta, Hironori Nomoto, Kazumiki Sonoda, Kazumasa Arima, Ken Kogawa, Rikitake Takahashi, Fumiyuki Kotani, Tomobumi Okubo, Kimie Fukushima, Seiji Itou, Satoru Kondo, Kunio Chiku, Masaaki Ohno, Yasumi Onikura, Motoyuki Hirayama, Atsushi On Behalf Of The Sakura Af Registry Investigators |
| description | Atrial fibrillation (AF) and chronic kidney disease (CKD) often coexist, but the real-world data after approval of direct oral anticoagulants (DOACs) are still lacking in Japan. We investigated the association of the baseline renal function and adverse clinical events and risk of adverse clinical events with DOACs compared to warfarin for each renal functional level in Japanese AF patients.
The present substudy was based on the SAKURA AF Registry, a Japanese multicenter observational registry (median follow-up period: 39 months). The creatinine clearance (CrCl) values were estimated by the Cockcroft-Gault formula, and divided into normal renal function, and mild and moderate-severe CKD (CrCl ≥ 80, 50-79, |
| doi_str_mv | 10.3390/jcm9010167 |
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The present substudy was based on the SAKURA AF Registry, a Japanese multicenter observational registry (median follow-up period: 39 months). The creatinine clearance (CrCl) values were estimated by the Cockcroft-Gault formula, and divided into normal renal function, and mild and moderate-severe CKD (CrCl ≥ 80, 50-79, <50 mL/min).
In the SAKURA AF Registry, the baseline CrCl data were available for 3242 patients (52% for DOAC and 48% for warfarin user). The relative risk of adverse clinical events was significantly higher in the patients with a CrCl < 50 mL/min as compared to those with a CrCl ≥ 80 mL/min (adjusted HRs: 2.53 for death, 2.53 for cardiovascular [CV] events, 2.13 for strokes, and 1.83 for major bleeding). Risks of all adverse clinical events were statistically even between DOAC and warfarin users for each renal function level.
Moderate-severe CKD was associated with a higher mortality, CV events, strokes, and major bleeding than normal renal function. The safety and effectiveness of DOACs over warfarin were similar for each renal function level. By a worsening renal function, the incidence of adverse clinical events increased, especially deaths and CV events as compared to strokes and major bleeding.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm9010167</identifier><identifier>PMID: 31936260</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Anticoagulants ; Cardiac arrhythmia ; Clinical medicine ; Clinical outcomes ; Creatinine ; Diabetes ; Enrollments ; Heart failure ; Hospitals ; Hypertension ; Laboratories ; Patients ; Stroke</subject><ispartof>Journal of clinical medicine, 2020-01, Vol.9 (1), p.167</ispartof><rights>2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 by the authors. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c406t-bfe1d9d1c11b7eba8d369b3e1bc5ff58cb573d5a11faf484edfe64fbffec73583</citedby><cites>FETCH-LOGICAL-c406t-bfe1d9d1c11b7eba8d369b3e1bc5ff58cb573d5a11faf484edfe64fbffec73583</cites><orcidid>0000-0002-4887-6920 ; 0000-0002-1592-4041</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7019418/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7019418/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31936260$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yuzawa, Yasuhumi</creatorcontrib><creatorcontrib>Kuronuma, Keiichiro</creatorcontrib><creatorcontrib>Okumura, Yasuo</creatorcontrib><creatorcontrib>Yokoyama, Katsuaki</creatorcontrib><creatorcontrib>Matsumoto, Naoya</creatorcontrib><creatorcontrib>Tachibana, Eizo</creatorcontrib><creatorcontrib>Oiwa, Koji</creatorcontrib><creatorcontrib>Matsumoto, Michiaki</creatorcontrib><creatorcontrib>Kojima, Toshiaki</creatorcontrib><creatorcontrib>Haruta, Hironori</creatorcontrib><creatorcontrib>Nomoto, Kazumiki</creatorcontrib><creatorcontrib>Sonoda, Kazumasa</creatorcontrib><creatorcontrib>Arima, Ken</creatorcontrib><creatorcontrib>Kogawa, Rikitake</creatorcontrib><creatorcontrib>Takahashi, Fumiyuki</creatorcontrib><creatorcontrib>Kotani, Tomobumi</creatorcontrib><creatorcontrib>Okubo, Kimie</creatorcontrib><creatorcontrib>Fukushima, Seiji</creatorcontrib><creatorcontrib>Itou, Satoru</creatorcontrib><creatorcontrib>Kondo, Kunio</creatorcontrib><creatorcontrib>Chiku, Masaaki</creatorcontrib><creatorcontrib>Ohno, Yasumi</creatorcontrib><creatorcontrib>Onikura, Motoyuki</creatorcontrib><creatorcontrib>Hirayama, Atsushi</creatorcontrib><creatorcontrib>On Behalf Of The Sakura Af Registry Investigators</creatorcontrib><creatorcontrib>on behalf of the SAKURA AF Registry Investigators</creatorcontrib><title>Relationship between the Renal Function and Adverse Clinical Events in Patients with Atrial Fibrillation: A Japanese Multicenter Registry Substudy</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><description>Atrial fibrillation (AF) and chronic kidney disease (CKD) often coexist, but the real-world data after approval of direct oral anticoagulants (DOACs) are still lacking in Japan. We investigated the association of the baseline renal function and adverse clinical events and risk of adverse clinical events with DOACs compared to warfarin for each renal functional level in Japanese AF patients.
The present substudy was based on the SAKURA AF Registry, a Japanese multicenter observational registry (median follow-up period: 39 months). The creatinine clearance (CrCl) values were estimated by the Cockcroft-Gault formula, and divided into normal renal function, and mild and moderate-severe CKD (CrCl ≥ 80, 50-79, <50 mL/min).
In the SAKURA AF Registry, the baseline CrCl data were available for 3242 patients (52% for DOAC and 48% for warfarin user). The relative risk of adverse clinical events was significantly higher in the patients with a CrCl < 50 mL/min as compared to those with a CrCl ≥ 80 mL/min (adjusted HRs: 2.53 for death, 2.53 for cardiovascular [CV] events, 2.13 for strokes, and 1.83 for major bleeding). Risks of all adverse clinical events were statistically even between DOAC and warfarin users for each renal function level.
Moderate-severe CKD was associated with a higher mortality, CV events, strokes, and major bleeding than normal renal function. The safety and effectiveness of DOACs over warfarin were similar for each renal function level. By a worsening renal function, the incidence of adverse clinical events increased, especially deaths and CV events as compared to strokes and major bleeding.</description><subject>Anticoagulants</subject><subject>Cardiac arrhythmia</subject><subject>Clinical medicine</subject><subject>Clinical outcomes</subject><subject>Creatinine</subject><subject>Diabetes</subject><subject>Enrollments</subject><subject>Heart 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Matsumoto, Michiaki ; Kojima, Toshiaki ; Haruta, Hironori ; Nomoto, Kazumiki ; Sonoda, Kazumasa ; Arima, Ken ; Kogawa, Rikitake ; Takahashi, Fumiyuki ; Kotani, Tomobumi ; Okubo, Kimie ; Fukushima, Seiji ; Itou, Satoru ; Kondo, Kunio ; Chiku, Masaaki ; Ohno, Yasumi ; Onikura, Motoyuki ; Hirayama, Atsushi ; On Behalf Of The Sakura Af Registry Investigators</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c406t-bfe1d9d1c11b7eba8d369b3e1bc5ff58cb573d5a11faf484edfe64fbffec73583</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Anticoagulants</topic><topic>Cardiac arrhythmia</topic><topic>Clinical medicine</topic><topic>Clinical outcomes</topic><topic>Creatinine</topic><topic>Diabetes</topic><topic>Enrollments</topic><topic>Heart 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clinical medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yuzawa, Yasuhumi</au><au>Kuronuma, Keiichiro</au><au>Okumura, Yasuo</au><au>Yokoyama, Katsuaki</au><au>Matsumoto, Naoya</au><au>Tachibana, Eizo</au><au>Oiwa, Koji</au><au>Matsumoto, Michiaki</au><au>Kojima, Toshiaki</au><au>Haruta, Hironori</au><au>Nomoto, Kazumiki</au><au>Sonoda, Kazumasa</au><au>Arima, Ken</au><au>Kogawa, Rikitake</au><au>Takahashi, Fumiyuki</au><au>Kotani, Tomobumi</au><au>Okubo, Kimie</au><au>Fukushima, Seiji</au><au>Itou, Satoru</au><au>Kondo, Kunio</au><au>Chiku, Masaaki</au><au>Ohno, Yasumi</au><au>Onikura, Motoyuki</au><au>Hirayama, Atsushi</au><au>On Behalf Of The Sakura Af Registry Investigators</au><aucorp>on behalf of the SAKURA AF Registry Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relationship between the Renal Function and Adverse Clinical Events in Patients with Atrial Fibrillation: A Japanese Multicenter Registry Substudy</atitle><jtitle>Journal of clinical medicine</jtitle><addtitle>J Clin Med</addtitle><date>2020-01-08</date><risdate>2020</risdate><volume>9</volume><issue>1</issue><spage>167</spage><pages>167-</pages><issn>2077-0383</issn><eissn>2077-0383</eissn><abstract>Atrial fibrillation (AF) and chronic kidney disease (CKD) often coexist, but the real-world data after approval of direct oral anticoagulants (DOACs) are still lacking in Japan. We investigated the association of the baseline renal function and adverse clinical events and risk of adverse clinical events with DOACs compared to warfarin for each renal functional level in Japanese AF patients.
The present substudy was based on the SAKURA AF Registry, a Japanese multicenter observational registry (median follow-up period: 39 months). The creatinine clearance (CrCl) values were estimated by the Cockcroft-Gault formula, and divided into normal renal function, and mild and moderate-severe CKD (CrCl ≥ 80, 50-79, <50 mL/min).
In the SAKURA AF Registry, the baseline CrCl data were available for 3242 patients (52% for DOAC and 48% for warfarin user). The relative risk of adverse clinical events was significantly higher in the patients with a CrCl < 50 mL/min as compared to those with a CrCl ≥ 80 mL/min (adjusted HRs: 2.53 for death, 2.53 for cardiovascular [CV] events, 2.13 for strokes, and 1.83 for major bleeding). Risks of all adverse clinical events were statistically even between DOAC and warfarin users for each renal function level.
Moderate-severe CKD was associated with a higher mortality, CV events, strokes, and major bleeding than normal renal function. The safety and effectiveness of DOACs over warfarin were similar for each renal function level. By a worsening renal function, the incidence of adverse clinical events increased, especially deaths and CV events as compared to strokes and major bleeding.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>31936260</pmid><doi>10.3390/jcm9010167</doi><orcidid>https://orcid.org/0000-0002-4887-6920</orcidid><orcidid>https://orcid.org/0000-0002-1592-4041</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2077-0383 |
| ispartof | Journal of clinical medicine, 2020-01, Vol.9 (1), p.167 |
| issn | 2077-0383 2077-0383 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7019418 |
| source | MDPI - Multidisciplinary Digital Publishing Institute; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; PubMed Central Open Access |
| subjects | Anticoagulants Cardiac arrhythmia Clinical medicine Clinical outcomes Creatinine Diabetes Enrollments Heart failure Hospitals Hypertension Laboratories Patients Stroke |
| title | Relationship between the Renal Function and Adverse Clinical Events in Patients with Atrial Fibrillation: A Japanese Multicenter Registry Substudy |
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