TY - JOUR
T1 - Frailty and outcomes in older adults with non-valvular atrial fibrillation from the ANAFIE registry
AU - Akishita, Masahiro
AU - Suzuki, Shinya
AU - Inoue, Hiroshi
AU - Akao, Masaharu
AU - Atarashi, Hirotsugu
AU - Ikeda, Takanori
AU - Koretsune, Yukihiro
AU - Okumura, Ken
AU - Shimizu, Wataru
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 - Yamashita, Takeshi
N1 - Funding Information:
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 Keyra Martinez Dunn, MD, of Edanz (www.edanz.com) for providing medical writing support, which was funded by Daiichi Sankyo Co. Ltd, in accordance with Good Publication Practice (GPP3) guidelines (http://www.ismpp.org/gpp3). In addition, the authors thank Daisuke Chiba of Daiichi Sankyo Co. Ltd. for support in the preparation of the manuscript. The study sponsor contributed writing, review, revision, and approval of the manuscript.
Funding Information:
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 Keyra Martinez Dunn, MD, of Edanz ( www.edanz.com ) for providing medical writing support, which was funded by Daiichi Sankyo Co., Ltd, in accordance with Good Publication Practice (GPP3) guidelines ( http://www.ismpp.org/gpp3 ). In addition, the authors thank Daisuke Chiba of Daiichi Sankyo Co., Ltd., for support in the preparation of the manuscript.
Funding Information:
MAki received research funding from Astellas, Bayer Healthcare, Chugai Pharmaceutical, Daiichi Sankyo, Eisai, Kracie Pharma, Merck Sharp & Dohme, Mitsubishi Tanabe, Ono Pharmaceutical, Takeda, Teijin Pharma, and Tsumura, and remuneration from Daiichi Sankyo and Merck Sharp & Dohme. SS received research funding from Mitsubishi-Tanabe and Daiichi Sankyo, and remuneration from Bristol-Myers Squibb and Daiichi Sankyo. HI received remuneration from Daiichi Sankyo, Bayer, Bristol-Myers Squibb, and Nippon Boehringer Ingelheim. MAka received research funding from Bayer and Daiichi Sankyo, and remuneration from Bristol-Myers Squibb, Nippon Boehringer Ingelheim, Bayer, and Daiichi Sankyo. HA received remuneration from Daiichi Sankyo. TI received research funding from Daiichi Sankyo and Bayer, and remuneration from Daiichi Sankyo, Bayer, Nippon Boehringer Ingelheim, and Bristol-Myers Squibb. YK received remuneration from Daiichi Sankyo, Bayer, and Nippon Boehringer Ingelheim. KO received remuneration from Nippon Boehringer Ingelheim, Daiichi Sankyo, Johnson & Johnson, and Medtronic. WS received research funding from Bristol-Myers Squibb, Daiichi Sankyo, and Nippon Boehringer Ingelheim, and patent royalties/licensing fees from Daiichi Sankyo, Pfizer Japan, Bristol-Myers Squibb, Bayer, and Nippon Boehringer Ingelheim. HT received research funding from Daiichi Sankyo and Nippon Boehringer Ingelheim, remuneration from Daiichi Sankyo, Bayer, Nippon Boehringer Ingelheim, and Pfizer Japan, scholarship funding from Daiichi Sankyo, and consultancy fees from Pfizer Japan, Bayer, and Nippon Boehringer Ingelheim. KT received remuneration from Daiichi Sankyo, Bayer, Bristol-Myers Squibb, and Takeda. AH participated in a course endowed by Boston Scientific Japan, has received research funding from Daiichi Sankyo and Bayer, and remuneration from Bayer, Daiichi Sankyo, Bristol-Myers Squibb, and Nippon Boehringer Ingelheim. MY received research funding from Nippon Boehringer Ingelheim, and remuneration from Nippon Boehringer Ingelheim, Daiichi Sankyo, Bayer, Bristol-Myers Squibb, and Pfizer Japan. TYamag acted as an Advisory Board member of Daiichi Sankyo and received remuneration from Daiichi Sankyo and Bristol-Myers Squibb. ST received research funding from Nippon Boehringer Ingelheim and remuneration from Daiichi Sankyo, Sanofi, Takeda, Chugai Pharmaceutical, Solasia Pharma, Bayer, Sysmex, Nipro, NapaJen Pharma, Gunze, and Atworking. TK, YM, and AT are employees of Daiichi Sankyo. TYamas received research funding from Bristol-Myers Squibb, Bayer, and Daiichi Sankyo, manuscript fees from Daiichi Sankyo and Bristol-Myers Squibb, and remuneration from Daiichi Sankyo, Bayer, Pfizer Japan, and Bristol-Myers Squibb.
Funding Information:
This work was supported by Daiichi Sankyo Co., Ltd.
Publisher Copyright:
© 2022 The Authors
PY - 2022/7/1
Y1 - 2022/7/1
N2 - Purpose: We aimed to determine the proportion of frail patients among older adults with non-valvular atrial fibrillation (NVAF), characterize them and their use of anticoagulant therapy, and examine the association between frailty and clinical outcomes in a real-world setting using the ANAFIE Registry dataset. Methods: The target population consisted of more than 30,000 adults aged ≥75 years definitively diagnosed with NVAF by electrocardiogram. For this sub-cohort study, patients who answered the Kihon Checklist were registered prospectively. Patients were classified into robust, pre-frail, and frail groups based on the Kihon Checklist score. Results: Of the 32,275 patients in the ANAFIE Registry, 2951 were enrolled in this subanalysis and responded to the Kihon Checklist: 959 (32.5%) patients were robust; 924 (31.3%), pre-frail; and 1068 (36.2%), frail. In the robust, pre-frail, and frail groups, respectively, the 2-year cumulative incidence rates of stroke/systemic embolic events were 2.4%, 3.3%, and 4.5%, (P = .025); all-cause death, 2.9%, 5.1%, and 13.7%, (P < .001); major bleeding, 1.5%, 1.2%, and 2.9%, (P = .029); and net clinical outcomes, 5.5%, 8.2%, and 17.1% (P < .001). Results were similar when comparing the robust+pre-frail vs frail groups. In multivariate analyses, cardiovascular death, all-cause death, and net clinical outcomes were significantly associated with frailty. In the robust+pre-frail vs frail groups, major bleeding was also associated with frailty. Conclusions: Frailty was associated with cardiovascular and all-cause death, net clinical outcomes, and major bleeding but not stroke or intracranial hemorrhage in older Japanese adults with NVAF.
AB - Purpose: We aimed to determine the proportion of frail patients among older adults with non-valvular atrial fibrillation (NVAF), characterize them and their use of anticoagulant therapy, and examine the association between frailty and clinical outcomes in a real-world setting using the ANAFIE Registry dataset. Methods: The target population consisted of more than 30,000 adults aged ≥75 years definitively diagnosed with NVAF by electrocardiogram. For this sub-cohort study, patients who answered the Kihon Checklist were registered prospectively. Patients were classified into robust, pre-frail, and frail groups based on the Kihon Checklist score. Results: Of the 32,275 patients in the ANAFIE Registry, 2951 were enrolled in this subanalysis and responded to the Kihon Checklist: 959 (32.5%) patients were robust; 924 (31.3%), pre-frail; and 1068 (36.2%), frail. In the robust, pre-frail, and frail groups, respectively, the 2-year cumulative incidence rates of stroke/systemic embolic events were 2.4%, 3.3%, and 4.5%, (P = .025); all-cause death, 2.9%, 5.1%, and 13.7%, (P < .001); major bleeding, 1.5%, 1.2%, and 2.9%, (P = .029); and net clinical outcomes, 5.5%, 8.2%, and 17.1% (P < .001). Results were similar when comparing the robust+pre-frail vs frail groups. In multivariate analyses, cardiovascular death, all-cause death, and net clinical outcomes were significantly associated with frailty. In the robust+pre-frail vs frail groups, major bleeding was also associated with frailty. Conclusions: Frailty was associated with cardiovascular and all-cause death, net clinical outcomes, and major bleeding but not stroke or intracranial hemorrhage in older Japanese adults with NVAF.
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U2 - 10.1016/j.archger.2022.104661
DO - 10.1016/j.archger.2022.104661
M3 - Article
C2 - 35303601
AN - SCOPUS:85126571757
SN - 0167-4943
VL - 101
JO - Archives of Gerontology and Geriatrics
JF - Archives of Gerontology and Geriatrics
M1 - 104661
ER -