Predictors for Stroke and Death in Non-Anticoagulated Asian Patients with Atrial Fibrillation: The Fushimi AF Registry
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Key result
Age, underweight, and specific comorbidities are linked to substantially higher major event risk in non-anticoagulated AF.
- n=1,541
Population
1,541 Japanese patients with atrial fibrillation not receiving oral anticoagulants at baseline. Mean age…
Design
Cohort
Follow-up
median 736 days
Authors
Discussion
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Implication
May inform risk stratification in non-anticoagulated AF; hypothesis-generating and requires prospective validation before guiding practice.
Study Design
Type
Cohort (n=1,541)
Multicenter
Yes
Structured PICO
P
Population
1,541 Japanese patients with atrial fibrillation not receiving oral anticoagulants (OAC) at baseline (from a total cohort of 3,304 with follow-up data). Mean age 73.1 ± 12.5 years, 44% female. Community-based 'all-comers' registry in Fushimi-ku, Kyoto, Japan.
O
Outcome
Composite of death, stroke, and systemic embolism (SE) during follow-upcomposite
In non-anticoagulated Japanese patients with atrial fibrillation, advanced age, underweight, previous stroke/TIA, heart failure, chronic kidney disease, and anemia independently predict the composite risk of death, stroke, or systemic embolism.
Limitations
- Observational study providing only associative evidence, not causative
- OAC prescribed to only 53% of all participating patients
- Did not collect data on time in therapeutic range for patients with warfarin
- Missing BMI and hemoglobin data for some patients leading to selection bias
- Underpowered to detect the impact of some risk factors like hypertension and diabetes mellitus
- All enrolled patients were Japanese, limiting generalizability to other populations
Cite This Study
Hamatani et al. (2015) conducted a cohort in Atrial fibrillation (n=1,541). Risk factors (advanced age, underweight, previous stroke/SE/TIA, heart failure, CKD, anemia) was evaluated on death, stroke, and systemic embolism (SE). In non-anticoagulated AF patients, advanced age, underweight, previous stroke/TIA, heart failure, CKD, and anemia independently predicted death, stroke, or systemic embolism (HRs 1.53 to 2.41).
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