Target international normalized ratio values for preventing thromboembolic and hemorrhagic events in Japanese patients with non-valvular atrial fibrillation: Results of the J-RHYTHM registry

Hiroshi Inoue, Ken Okumura, Hirotsugu Atarashi, Takeshi Yamashita, Hideki Origasa, Naoko Kumagai, Masayuki Sakurai, Yuichiro Kawamura, Isao Kubota, Kazuo Matsumoto, Yoshiaki Kaneko, Satoshi Ogawa, Yoshifusa Aizawa, Masaomi Chinushi, Itsuo Kodama, Eiichi Watanabe, Yukihiro Koretsune, Yuji Okuyama, Akihiko Shimizu, Osamu IgawaShigenobu Bando, Masahiko Fukatani, Tetsunori Saikawa, Akiko Chishaki

研究成果: ジャーナルへの寄稿記事

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Background: Target anticoagulation levels for warfarin in Japanese patients with non-valvular atrial fibrillation (NVAF) are unclear. Methods and Results: Of 7,406 patients with NVAF, 1,002 did not receive warfarin (non-warfarin group), and the remaining patients receiving warfarin were divided into 5 groups based on their baseline international normalized ratio (INR) of prothrombin time (≤1.59, 1.6-1.99, 2.0-2.59, 2.6-2.99, and ≥3.0). Patients were followed-up prospec-tively for 2 years. Primary endpoints were thromboembolic events (cerebral infarction, transient ischemic attack, and systemic embolism), and major hemorrhage requiring hospital admission. During the follow-up period, thromboem-bolic events occurred in 3.0% of non-warfarin group, but at lower frequencies in the warfarin groups (2.0, 1.3, 1.5, 0.6, and 1.8%/2 years for INR values of ≤1.59, 1.6-1.99, 2.0-2.59, 2.6-2.99, and ≥3.0, respectively; P=0.0059). Major hemorrhage occurred more frequently in warfarin groups (1.5, 1.8, 2.4, 3.3, and 4.1% for INR values ≤1.59, 1.6-1.99, 2.0-2.59, 2.6-2.99, and ≥3.0, respectively; P=0.0041) than in non-warfarin group (0.8%/2 years). These trends were maintained when the analyses were confined to patients aged ≥70 years. Conclusions: An INR of 1.6-2.6 is safe and effective at preventing thromboembolic events in patients with NVAF, particularly patients aged ≥70 years. An INR of 2.6-2.99 is also effective, but associated with a slightly increased risk in major hemorrhage.

元の言語英語
ページ(範囲)2264-2270
ページ数7
ジャーナルCirculation Journal
77
発行部数9
DOI
出版物ステータス出版済み - 8 28 2013

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All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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