Papers

Peer-reviewed
Nov 25, 2019

Current Status and Clinical Outcomes of Oral Anticoagulant Discontinuation After Ablation for Atrial Fibrillation in Japan - Findings From the AF Frontier Ablation Registry.

Circulation journal : official journal of the Japanese Circulation Society
  • 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
  • Display all

Volume
83
Number
12
First page
2418
Last page
2427
Language
English
Publishing type
Research paper (scientific journal)
DOI
10.1253/circj.CJ-19-0602

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.

Link information
DOI
https://doi.org/10.1253/circj.CJ-19-0602
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/31619591
ID information
  • DOI : 10.1253/circj.CJ-19-0602
  • Pubmed ID : 31619591

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