- 著者
-
Yasuo Okumura
Katsuaki Yokoyama
Naoya Matsumoto
Eizo Tachibana
Keiichiro Kuronuma
Koji Oiwa
Michiaki Matsumoto
Toshiaki Kojima
Shoji Hanada
Kazumiki Nomoto
Ken Arima
Fumiyuki Takahashi
Tomobumi Kotani
Yukitoshi Ikeya
Seiji Fukushima
Satoru Itou
Kunio Kondo
Masaaki Chiku
Yasumi Ohno
Motoyuki Onikura
Atsushi Hirayama
for the SAKURA AF Registry Investigators
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.82, no.10, pp.2500-2509, 2018-09-25 (Released:2018-09-25)
- 参考文献数
- 20
- 被引用文献数
-
55
Background: Although direct oral anticoagulants (DOACs) are widely used in Japanese patients with atrial fibrillation (AF), large-scale investigations into their use, with suitable follow-up times and rates, are lacking. Methods and Results: The SAKURA AF Registry is a prospective multicenter registry created to investigate therapeutic outcomes of oral anticoagulant (OAC) use in Japanese AF patients. We conducted a study involving 3,237 enrollees from 63 institutions in the Tokyo area being treated with any of 4 DOACs (n=1,676) or warfarin (n=1,561) and followed-up for a median of 39.3 months (range 28.5–43.6 months). Analyses of 1- and 2-year follow-up data available for 3,157 (97.5%) and 2,952 (91.2%) patients, respectively, showed no significant differences in rates of stroke or systemic embolism (SE), major bleeding, and all-cause mortality for DOAC vs. warfarin users (1.2 vs. 1.8%/year, 0.5 vs. 1.2%/year, and 2.1 vs. 1.7%/year, respectively). Under propensity score matching, the incidence of stroke or SE (P=0.679) and all-cause death (P=0.864) remained equivalent, but the incidence of major bleeding was significantly lower (P=0.014) among DOAC than warfarin users. Conclusions: A high follow-up rate allowed us to obtain reliable data on the status of OAC use and therapeutic outcomes among AF patients in Japan. Warfarin and DOACs appear to yield equivalent 3-year stroke and all-cause mortality rates, but DOACs appear to reduce the risk of major bleeding.