- 著者
- Nozawa Takashi Inoue Hiroshi Iwasa Atsushi Okumura Ken Lee Jong-dae Shimizu Akihiko Hayano Motonobu Yano Katsusuke
- 出版者
- 社団法人日本循環器学会
- 雑誌
- Circulation journal : official journal of the Japanese Circulation Society (ISSN:13469843)
- 巻号頁・発行日
- vol.68, no.1, pp.29-34, 2003-12-20
- 被引用文献数
- 11 41
Background Elevation of hemostatic markers may account for the increased risk of ischemic stroke in patients with non-valvular atrial fibrillation (NVAF). The aim of this study was to determine the effects of anticoagulation intensity on hemostatic markers in patients with NVAF. Methods and Results In 509 patients with NVAF, comprising 263 patients treated with warfarin and 246 patients without warfarin, the hemostatic markers of prothrombin fragment F1.2 (F1.2), fibrin D-dimer, platelet factor 4 (PF4), and β-thromboglobulin were determined and compared with those in 111 patients with sinus rhythm. F1.2 was inversely related with anticoagulation intensity and D-dimer increased with age. All hemostatic markers, except F1.2, were greater in patients with NVAF than in patients with sinus rhythm. F1.2 and D-dimer were significantly lower in patients with international normalized ratio (INR) ≥ 1.5 than in NVAF patients without warfarin and were not different between NVAF patients with INR of 1.5-1.9 and with INR ≥ 2.0. Conclusions Low intensity of anticoagulation (INR 1.5-1.9) suppresses the elevated concentration of F1.2 and D-dimer in patients with NVAF, and might be favorable in Japanese patients with NVAF in view of the balance between prevention of thromboembolism and the adverse effect by warfarin (ie, bleeding).
- 著者
- Yamashita Takeshi Ogawa Satoshi Aizawa Yoshifusa Atarashi Hirotsugu Inoue Hiroshi Ohe Tohru Okumura Ken Kato Takao Kamakura Shiro Kumagai Koichiro Kurachi Yoshihisa Kodama Itsuo Koretsune Yukihiro Saikawa Tetsunori Sakurai Masayuki Sugi Kaoru Nakaya Haruaki Nakayama Toshio Hirai Makoto Fukatani Masahiko Mitamura Hideo Yamazaki Tsutomu
- 出版者
- 社団法人日本循環器学会
- 雑誌
- Circulation journal : official journal of the Japanese Circulation Society (ISSN:13469843)
- 巻号頁・発行日
- vol.67, no.9, pp.738-741, 2003-08-20
- 被引用文献数
- 22 50
The Japanese Rhythm Management Trial for Atrial Fibrillation (J-RHYTHM study) is a randomized comparative evaluation of rate control and rhythm control, both combined with antithrombotic therapy, as therapeutic strategies for the treatment of atrial fibrillation (AF). This study differs from the earlier AFFIRM and RACE studies in that it has a composite primary end-point representing mortality and also physical/psychological disablement (total mortality, symptomatic cerebral infarction, systemic embolism, major bleeding, hospitalization for heart failure requiring intravenous administration of diuretics, and patient disablement). Patients' will to change the therapeutic strategy to the other is also considered as an end-point representing disablement under the assigned strategy. The secondary end-point includes quality of life scores and the efficacy and safety of drugs used in treating AF. The J-RHYTHM study emphasizes patient-reported experience and perception of AF-specific disablement, and the safety of antiarrhythmics available in Japan; it will follow 2,600 patients treated at more than 150 sites in Japan for a 3-year period. (Circ J 2003; 67: 738-741)