- 著者
-
Yasuo Okumura
Koichi Nagashima
Masaru Arai
Ryuta Watanabe
Katsuaki Yokoyama
Naoya Matsumoto
Takayuki Otsuka
Shinya Suzuki
Akio Hirata
Masato Murakami
Mitsuru Takami
Masaomi Kimura
Hidehira Fukaya
Shiro Nakahara
Takeshi Kato
Wataru Shimizu
Yu-ki Iwasaki
Hiroshi Hayashi
Tomoo Harada
Ikutaro Nakajima
Ken Okumura
Junjiroh Koyama
Michifumi Tokuda
Teiichi Yamane
Yukihiko Momiyama
Kojiro Tanimoto
Kyoko Soejima
Noriko Nonoguchi
Koichiro Ejima
Nobuhisa Hagiwara
Masahide Harada
Kazumasa Sonoda
Masaru Inoue
Koji Kumagai
Hidemori Hayashi
Kazuhiro Satomi
Yoshinao Yazaki
Yuji Watari
on behalf of the AF Ablation Frontier Registry
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.83, no.12, pp.2418-2427, 2019-11-25 (Released:2019-11-25)
- 参考文献数
- 27
- 被引用文献数
-
17
Background:The safety of discontinuing oral anticoagulant (OAC) after ablation for atrial fibrillation (AF) in Japanese patients has not been clarified.Methods and Results:A study based on the Atrial Fibrillation registry to Follow the long-teRm Outcomes and use of aNTIcoagulants aftER Ablation (AF Frontier Ablation Registry) was conducted. Data were collected from 3,451 consecutive patients (74.1% men; age, 63.3±10.3 years) who had undergone AF ablation at any of 24 cardiovascular centers in Japan between August 2011 and July 2017. During a 20.7-month follow-up period, OAC therapy was discontinued in 1,836 (53.2%) patients; 51 patients (1.5%) suffered a stroke/transient ischemic attack (TIA), 71 (2.1%) suffered major bleeding, and 36 (1.0%) died. Patients in whom OAC therapy was discontinued were significantly younger than those in whom OACs were continued, and their CHA2DS2-VASc scores were significantly lower. The incidences of stroke/TIA, major bleeding, and death were significantly lower among these patients. Upon multivariate adjustment, stroke events were independently associated with relatively high baseline CHA2DS2-VASc scores but not with OAC status.Conclusions:Although the incidences of stroke/TIA, major bleeding, and death were relatively low among patients for whom OAC therapy was discontinued, stroke/TIA occurrence was strongly associated with a high baseline stroke risk rather than with OAC status. Thus, discontinuation of OAC therapy requires careful consideration, especially in patients with a high baseline stroke risk.