Clinical features and prognosis in patients with atrial fibrillation and prior stroke: Comparing the Fushimi and Darlington AF Registries

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Clinical features and prognosis in patients with atrial fibrillation and prior stroke: Comparing the Fushimi and Darlington AF Registries. / Ogawa, Hisashi; Senoo, Keitaro; An, Yoshimori; Shantsila, Alena; Shantsila, Eduard; Lane, Deirdre; Wolff, Andreas; Akao, Masaharu; Lip, Gregory.

In: EBioMedicine, Vol. 18, 01.04.2017, p. 199-203.

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@article{844809bdee0e4d50956c9981eac498ca,
title = "Clinical features and prognosis in patients with atrial fibrillation and prior stroke: Comparing the Fushimi and Darlington AF Registries",
abstract = "Background Ethnic differences in clinical characteristics, stroke risk profiles and outcomes among atrial fibrillation (AF) patients may exist. We therefore compared AF patients with previous stroke from Japan and the United Kingdom (UK). Methods We compared clinical characteristics, stroke risk and outcomes among AF patients from the Fushimi AF registry who had experienced a previous stroke (Japan; n = 688; 19.7%) and the Darlington AF registry (UK; n = 428; 19.0%). Results AF patients with previous stroke in Fushimi were significantly younger (76.8 and 79.6 years of age in Fushimi and Darlington; p < 0.01) with a lower proportion of females (37.4% vs. 45.1%; p = 0.01) than those from Darlington. Although the CHA2DS2-VASc score was lower in AF patients in Fushimi than those in Darlington (5.18 vs. 5.57; p < 0.01), oral anticoagulation (OAC) was prescribed significantly more frequently in Fushimi (68.3%) than Darlington (61.7%) (p = 0.02). Multivariate logistic regression analysis showed that Japanese ethnicity was associated with a significantly decreased risk of recurrent stroke (OR 0.59. 95% CI 0.36–0.97; p = 0.04) but a significantly increased risk of all-cause mortality (OR 1.76, 95% CI 1.18–2.66; p < 0.01) in AF patients with previous stroke. Conclusions AF patients with previous stroke in the UK were at higher risk of recurrent stroke compared to Japanese patients, but OAC was utilised less frequently. There was a lower risk of recurrent stroke in the secondary prevention cohort from the Fushimi registry, but an increased risk of all-cause mortality.",
keywords = "Japan, United Kingdom, Atrial fibrillation, Previous stroke, Secondary prevention, Observational",
author = "Hisashi Ogawa and Keitaro Senoo and Yoshimori An and Alena Shantsila and Eduard Shantsila and Deirdre Lane and Andreas Wolff and Masaharu Akao and Gregory Lip",
year = "2017",
month = apr,
day = "1",
doi = "10.1016/j.ebiom.2017.03.022",
language = "English",
volume = "18",
pages = "199--203",
journal = "EBioMedicine",
issn = "2352-3964",
publisher = "Elsevier",

}

RIS

TY - JOUR

T1 - Clinical features and prognosis in patients with atrial fibrillation and prior stroke: Comparing the Fushimi and Darlington AF Registries

AU - Ogawa, Hisashi

AU - Senoo, Keitaro

AU - An, Yoshimori

AU - Shantsila, Alena

AU - Shantsila, Eduard

AU - Lane, Deirdre

AU - Wolff, Andreas

AU - Akao, Masaharu

AU - Lip, Gregory

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Background Ethnic differences in clinical characteristics, stroke risk profiles and outcomes among atrial fibrillation (AF) patients may exist. We therefore compared AF patients with previous stroke from Japan and the United Kingdom (UK). Methods We compared clinical characteristics, stroke risk and outcomes among AF patients from the Fushimi AF registry who had experienced a previous stroke (Japan; n = 688; 19.7%) and the Darlington AF registry (UK; n = 428; 19.0%). Results AF patients with previous stroke in Fushimi were significantly younger (76.8 and 79.6 years of age in Fushimi and Darlington; p < 0.01) with a lower proportion of females (37.4% vs. 45.1%; p = 0.01) than those from Darlington. Although the CHA2DS2-VASc score was lower in AF patients in Fushimi than those in Darlington (5.18 vs. 5.57; p < 0.01), oral anticoagulation (OAC) was prescribed significantly more frequently in Fushimi (68.3%) than Darlington (61.7%) (p = 0.02). Multivariate logistic regression analysis showed that Japanese ethnicity was associated with a significantly decreased risk of recurrent stroke (OR 0.59. 95% CI 0.36–0.97; p = 0.04) but a significantly increased risk of all-cause mortality (OR 1.76, 95% CI 1.18–2.66; p < 0.01) in AF patients with previous stroke. Conclusions AF patients with previous stroke in the UK were at higher risk of recurrent stroke compared to Japanese patients, but OAC was utilised less frequently. There was a lower risk of recurrent stroke in the secondary prevention cohort from the Fushimi registry, but an increased risk of all-cause mortality.

AB - Background Ethnic differences in clinical characteristics, stroke risk profiles and outcomes among atrial fibrillation (AF) patients may exist. We therefore compared AF patients with previous stroke from Japan and the United Kingdom (UK). Methods We compared clinical characteristics, stroke risk and outcomes among AF patients from the Fushimi AF registry who had experienced a previous stroke (Japan; n = 688; 19.7%) and the Darlington AF registry (UK; n = 428; 19.0%). Results AF patients with previous stroke in Fushimi were significantly younger (76.8 and 79.6 years of age in Fushimi and Darlington; p < 0.01) with a lower proportion of females (37.4% vs. 45.1%; p = 0.01) than those from Darlington. Although the CHA2DS2-VASc score was lower in AF patients in Fushimi than those in Darlington (5.18 vs. 5.57; p < 0.01), oral anticoagulation (OAC) was prescribed significantly more frequently in Fushimi (68.3%) than Darlington (61.7%) (p = 0.02). Multivariate logistic regression analysis showed that Japanese ethnicity was associated with a significantly decreased risk of recurrent stroke (OR 0.59. 95% CI 0.36–0.97; p = 0.04) but a significantly increased risk of all-cause mortality (OR 1.76, 95% CI 1.18–2.66; p < 0.01) in AF patients with previous stroke. Conclusions AF patients with previous stroke in the UK were at higher risk of recurrent stroke compared to Japanese patients, but OAC was utilised less frequently. There was a lower risk of recurrent stroke in the secondary prevention cohort from the Fushimi registry, but an increased risk of all-cause mortality.

KW - Japan

KW - United Kingdom

KW - Atrial fibrillation

KW - Previous stroke

KW - Secondary prevention

KW - Observational

U2 - 10.1016/j.ebiom.2017.03.022

DO - 10.1016/j.ebiom.2017.03.022

M3 - Article

VL - 18

SP - 199

EP - 203

JO - EBioMedicine

JF - EBioMedicine

SN - 2352-3964

ER -