TY - JOUR
T1 - Prognostic impact of heart rate during atrial fibrillation on clinical outcomes in elderly non-valvular atrial fibrillation patients
T2 - ANAFIE Registry sub-cohort study
AU - Ikeda, Takanori
AU - Yamashita, Takeshi
AU - Akao, Masaharu
AU - Atarashi, Hirotsugu
AU - Koretsune, Yukihiro
AU - Okumura, Ken
AU - Shimizu, Wataru
AU - Suzuki, Shinya
AU - Tsutsui, Hiroyuki
AU - Toyoda, Kazunori
AU - Hirayama, Atsushi
AU - Yasaka, Masahiro
AU - Yamaguchi, Takenori
AU - Teramukai, Satoshi
AU - Kimura, Tetsuya
AU - Morishima, Yoshiyuki
AU - Takita, Atsushi
AU - Inoue, Hiroshi
N1 - Funding Information:
This research was supported by Daiichi Sankyo Company, Limited .
Funding Information:
Some results of this study were previously presented as a poster presentation at the 86th Annual scientific meeting of the Japanese Circulation Society (JCS 2022), 11–13 March 2022, Japan. The authors wish to thank all individuals (physicians, nurses, institutional staff, and patients) involved in the ANAFIE Registry. They also thank IQVIA Services, Japan K.K. and EP-CRSU for their partial support in the conduct of this Registry, and Aafreen Saiyed of Edanz ( www.edanz.com ) for providing medical writing support, which was funded by Daiichi Sankyo Co. Ltd, in accordance with Good Publication Practice (GPP 2022) guidelines ( https://www.ismpp.org/gpp-2022 ). In addition, the authors thank Daisuke Chiba of Daiichi Sankyo Co. Ltd. for support in the preparation of the manuscript.
Funding Information:
Some results of this study were previously presented as a poster presentation at the 86th Annual scientific meeting of the Japanese Circulation Society (JCS 2022), 11–13 March 2022, Japan. The authors wish to thank all individuals (physicians, nurses, institutional staff, and patients) involved in the ANAFIE Registry. They also thank IQVIA Services, Japan K.K. and EP-CRSU for their partial support in the conduct of this Registry, and Aafreen Saiyed of Edanz (www.edanz.com) for providing medical writing support, which was funded by Daiichi Sankyo Co. Ltd, in accordance with Good Publication Practice (GPP 2022) guidelines (https://www.ismpp.org/gpp-2022). In addition, the authors thank Daisuke Chiba of Daiichi Sankyo Co. Ltd. for support in the preparation of the manuscript. This research was supported by Daiichi Sankyo Company, Limited.
Publisher Copyright:
© 2022 The Authors
PY - 2022
Y1 - 2022
N2 - Background: Elderly patients with atrial fibrillation (AF) are at a higher risk for all-cause mortality and heart failure. Rate control is an essential component in AF management. This exploratory study assessed the relationship between resting heart rate during AF at baseline and clinical outcomes in Japanese elderly non-valvular AF (NVAF) patients, using the All Nippon AF In the Elderly Registry (ANAFIE) dataset. Methods: This sub-cohort included patients who agreed to participate and presented with AF at enrollment in the ANAFIE study. They were categorized into six groups according to the resting heart rate during AF. Outcomes included 2-year cumulative incidences of stroke/systemic embolic events (SEE), ischemic stroke, major bleeding, cardiovascular (CV) events, CV death, all-cause death, and net clinical outcome, a composite of stroke/SEE, major bleeding, and all-cause death. Results: Of the 8292 patients included in this sub-cohort (paroxysmal, 1496; non-paroxysmal, 6796), 90 % of patients were using anticoagulants. Higher heart rate was more frequently reported in women and in patients with paroxysmal AF and was associated with increased use of direct oral anticoagulants (DOACs) and antiarrhythmic drugs. Heart rate ≥110 beats per minute (bpm) was associated with a significantly higher incidence of cardiac events and numerically higher incidences of CV death and all-cause death compared with a heart rate of 60 to <80 bpm, all of which were driven by an increased risk in patients with non-paroxysmal AF. Hazard ratios by the type of anticoagulant for each clinical outcome were comparable across all heart rate categories, indicating no significant interactions. Conclusions: Elderly Japanese patients with non-paroxysmal NVAF and a heart rate ≥110 bpm have an increased risk of cardiac events. There was no interaction between heart rate category and the relative risk of adverse clinical events in patients taking DOACs compared with those taking warfarin.
AB - Background: Elderly patients with atrial fibrillation (AF) are at a higher risk for all-cause mortality and heart failure. Rate control is an essential component in AF management. This exploratory study assessed the relationship between resting heart rate during AF at baseline and clinical outcomes in Japanese elderly non-valvular AF (NVAF) patients, using the All Nippon AF In the Elderly Registry (ANAFIE) dataset. Methods: This sub-cohort included patients who agreed to participate and presented with AF at enrollment in the ANAFIE study. They were categorized into six groups according to the resting heart rate during AF. Outcomes included 2-year cumulative incidences of stroke/systemic embolic events (SEE), ischemic stroke, major bleeding, cardiovascular (CV) events, CV death, all-cause death, and net clinical outcome, a composite of stroke/SEE, major bleeding, and all-cause death. Results: Of the 8292 patients included in this sub-cohort (paroxysmal, 1496; non-paroxysmal, 6796), 90 % of patients were using anticoagulants. Higher heart rate was more frequently reported in women and in patients with paroxysmal AF and was associated with increased use of direct oral anticoagulants (DOACs) and antiarrhythmic drugs. Heart rate ≥110 beats per minute (bpm) was associated with a significantly higher incidence of cardiac events and numerically higher incidences of CV death and all-cause death compared with a heart rate of 60 to <80 bpm, all of which were driven by an increased risk in patients with non-paroxysmal AF. Hazard ratios by the type of anticoagulant for each clinical outcome were comparable across all heart rate categories, indicating no significant interactions. Conclusions: Elderly Japanese patients with non-paroxysmal NVAF and a heart rate ≥110 bpm have an increased risk of cardiac events. There was no interaction between heart rate category and the relative risk of adverse clinical events in patients taking DOACs compared with those taking warfarin.
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UR - http://www.scopus.com/inward/citedby.url?scp=85145190929&partnerID=8YFLogxK
U2 - 10.1016/j.jjcc.2022.11.011
DO - 10.1016/j.jjcc.2022.11.011
M3 - Article
C2 - 36427691
AN - SCOPUS:85145190929
SN - 0914-5087
JO - Journal of Cardiology
JF - Journal of Cardiology
ER -