Publications by authors named "Atarashi H"
Aim: In this subanalysis of the EXPAND study, we evaluated the risks and benefits of rivaroxaban plus antiplatelet therapy (APT) for patients with non-valvular atrial fibrillation (NVAF) complicated by stable coronary artery disease (CAD), ischemic stroke, or peripheral artery disease (PAD).
Methods: From the EXPAND study population (n=7,141), patients with NVAF complicated by stable CAD (n=886), ischemic stroke (n=1,231), or PAD (n=160) were included. Patients complicated by any of them were set as ALL (n=2,030).
Article Synopsis
- The All Nippon Atrial Fibrillation In the Elderly Registry studied over 30,000 elderly Japanese patients with non-valvular atrial fibrillation, focusing on outcomes based on age and type of oral anticoagulants (OACs).
- Results showed that the incidence of stroke, major bleeding, and intracranial hemorrhage increased significantly with age, but plateaued for those aged 90 and over.
- Direct OACs (DOACs) generally resulted in lower event rates compared to warfarin, particularly in patients aged 75-85 years, but had limited effectiveness in reducing major bleeding for patients aged 90 and older, suggesting very-low-dose DOACs might be beneficial for this older
Article Synopsis
- * Out of 32,275 patients studied, 3.5% had GI bleeding, with lower and upper GI bleeding events being 760 and 339 respectively; factors increasing the risk included age over 85, higher body mass index, and use of multiple medications.
- * No significant difference in GI bleeding risk was observed between direct oral anticoagulant (DOAC) users and warfarin users, with a higher mortality rate after upper GI bleeding compared to lower GI bleeding
Article Synopsis
- A study analyzed data from over 30,000 Japanese patients aged 75 and older with non-valvular atrial fibrillation (AF) to understand the incidence and risk factors for coronary events (CE), including myocardial infarction (MI) and cardiac interventions.
- The 2-year follow-up found a CE incidence rate of 0.48 per 100 patient-years, with significant risk factors including male sex, high blood pressure, diabetes, previous CE history, and low creatinine clearance.
- Patients who experienced new-onset CE had a much higher risk of major bleeding compared to those without CE, highlighting the need for careful management in elderly AF patients.
Aims: Atrial fibrillation (AF) and heart failure (HF) often coexist. Older age is strongly associated with stroke, HF, and mortality. The association between coexistence of HF and a risk of clinical outcomes and the effectiveness of anticoagulation therapy including direct oral anticoagulants (DOACs) in elderly patients with AF and HF have not been investigated.
View Article and Find Full Text PDFWe present a case of orthodromic atrioventricular re-entrant tachycardia exhibiting both right and left bundle branch block pattern wide QRS morphologies caused by bilateral bystander nodoventricular (NV) accessory pathways. These wide QRS morphologies came from pre-excitation accompanied by delta waves. In the context of NV accessory pathways, left-sided manifest NV accessory pathways are rare.
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- A once-daily 15-mg dose of edoxaban has been approved for stroke prevention in patients aged ≥ 80 years with non-valvular atrial fibrillation (NVAF) at high bleeding risk (HBR) based on the ELDERCARE-AF trial.
- The study analyzed 7346 NVAF patients, dividing them into three groups based on age and HBR status to investigate their characteristics and clinical outcomes.
- Results showed that elderly NVAF patients with HBR (Group 3) had the highest risks for thromboembolism, major hemorrhage, and all-cause death during a 2-year follow-up, highlighting their need for careful management.
Article Synopsis
- This study assessed echocardiographic features of left atrial (LA) structure and function in patients aged 75 and older with non-valvular atrial fibrillation (AF) to see how these features related to health outcomes over two years.
- It involved 1,474 elderly patients, analyzing aspects like LA emptying fraction (LAEF) and maximum LA volume index (max. LAVi), revealing that lower LAEF and higher max. LAVi were linked to higher risks of cardiovascular events, heart failure hospitalizations, and overall mortality.
- The findings suggest that elderly patients with poor LA function and larger LA volume need closer monitoring and management for better outcomes.
Article Synopsis
- The EXPAND study analyzed the safety and efficacy of standard-dose (15 mg/day) versus reduced-dose (10 mg/day) rivaroxaban in older patients (≥65 years) with non-valvular atrial fibrillation (NVAF) and normal kidney function.
- No significant differences were found in major bleeding or thromboembolic events between the two doses; however, reduced-dose rivaroxaban was associated with a higher risk of myocardial infarction and related events.
- The findings suggest that using rivaroxaban at a standard dose of 15 mg/day is more favorable for patients aged ≥75 years with NVAF.
Article Synopsis
- The study investigates how coagulation biomarkers relate to clinical outcomes in elderly Japanese patients with atrial fibrillation (AF) treated with either direct oral anticoagulants (DOACs) or warfarin.
- It included patients aged 75 and older, assessing levels of biomarkers like D-dimer and thrombin-antithrombin complex (TAT) alongside their anticoagulant usage.
- The findings indicate that higher biomarker levels correlate with increased risks of cardiovascular events and mortality, with different associations observed between DOAC and warfarin users.
Article Synopsis
- A study of over 30,000 elderly Japanese patients with nonvalvular atrial fibrillation (NVAF) found that many had low comprehension of their condition, which was linked to poorer health outcomes.
- Among 1,968 patients assessed for understanding NVAF, 81.9% scored low, which was associated with a higher risk of serious complications like stroke and death.
- Additionally, while 64.9% of the 2,362 patients showed good adherence to anticoagulant therapy, those who were less adherent faced significantly worse prognoses and clinical outcomes.
Article Synopsis
- This study analyzed data from over 30,000 elderly Japanese patients with non-valvular atrial fibrillation to investigate the prevalence and impact of low doses of direct oral anticoagulants (DOACs).
- It found that a significant portion of patients were on under- or off-label doses and that factors such as older age, female sex, and certain medical histories were associated with these prescriptions.
- While low DOAC doses didn't increase the risk of stroke or major bleeding, they were linked to a higher rate of overall mortality among patients.
Background: This ANAFIE Registry sub-analysis investigated 2-year outcomes and oral anticoagulant (OAC) use stratified by glycated hemoglobin (HbA1c) levels among Japanese patients aged ≥ 75 years with non-valvular atrial fibrillation (NVAF) with and without clinical diagnosis of diabetes mellitus (DM).
Methods: The ANAFIE Registry was a large-scale multicenter, observational study conducted in Japan; this sub-analysis included patients with baseline HbA1c data at baseline. The main endpoints evaluated (stroke/systemic embolic events [SEE], major bleeding, intracranial hemorrhage, cardiovascular death, all-cause death, and net clinical outcome [a composite of stroke/SEE, major bleeding, and all-cause death]) were stratified by HbA1c levels (< 6.
The benefits of direct oral anticoagulants (DOACs) and warfarin in elderly Japanese patients with non-valvular atrial fibrillation (NVAF) and high home systolic blood pressure (H-SBP) are unclear. This sub-cohort study of the ANAFIE Registry estimated the incidence of clinical outcomes in patients receiving anticoagulant therapy (warfarin and DOACs) stratified by H-SBP levels (<125 mmHg, ≥125-<135 mmHg, ≥135-<145 mmHg and ≥145 mmHg). Of the overall ANAFIE population, 4933 patients who underwent home blood pressure (H-BP) measurements were analyzed; 93% received OACs (DOACs: 3494, 70.
View Article and Find Full Text PDFBackground: Advancing age, decreasing renal function, and atrial fibrillation are strongly associated. Real-world evidence of direct oral anticoagulant (DOAC) use among elderly patients ≥75 years of age with nonvalvular atrial fibrillation and renal dysfunction is limited.
Objectives: This study sought to assess 2-year outcomes and anticoagulant treatment, stratified by renal function.
Background: In current practice, the ablation target of atypical atrioventricular nodal re-entrant tachycardia (AVNRT) is the earliest atrial activation site in the coronary sinus (CS) or conventional slow pathway region.
Objectives: The purposes of this study were to map the site of earliest retrograde atrial activation using electroanatomic three-dimensional mapping during atypical AVNRT and to evaluate successful ablation sites.
Methods: A total of 42 patients with a total of 49 AVNRTs (slow/fast: 30; fast/slow: 15; slow/slow: 4) underwent electrophysiological study and ablation.
Background: We previously reported that standard deviation (SD) of systolic blood pressure (SBP), an index of BP variability, and SBP-time in target range (TTR), an index of BP consistency, were significantly associated with adverse events in patients with non-valvular atrial fibrillation (NVAF). Thus, this study aimed to compare predictive ability for adverse events among visit-to-visit BP variability/consistency indices using data from the J-RHYTHM Registry.
Methods: Of 7406 outpatients with NVAF, 7226 (age, 69.
Article Synopsis
- A study aimed to compare the risks of intracranial hemorrhage (ICH) and ischemic stroke between elderly patients with nonvalvular atrial fibrillation (NVAF) taking direct oral anticoagulants (DOACs) versus those on warfarin.
- The analysis involved over 32,000 patients aged 75 and older, revealing that those on DOACs had a significantly lower incidence of both ischemic strokes and various types of ICH compared to warfarin users during a follow-up period of about 1.88 years.
- Additionally, other characteristics like a history of cerebrovascular disease and persistent NVAF were identified as strong risk factors for ischemic stroke and ICH.
Background: Although anticoagulants are indicated for many elderly patients with non-valvular atrial fibrillation (NVAF), some patients do not receive anticoagulant therapy, whose characteristics and outcomes are diverse.
Methods And Results: In this sub-analysis of the All Nippon AF In the Elderly (ANAFIE) Registry, the phenotypes of patients who were not receiving anticoagulants at baseline were evaluated by cluster analysis using Ward's linkage hierarchical algorithm. Of 32,275 enrolled patients, 2445 (7.
Background: This subcohort study of All Nippon AF In the Elderly (ANAFIE) Registry based on 33 275 elderly patients (aged ≥75 years) with non-valvular atrial fibrillation (NVAF) investigated the relationship between cognitive function and 2-year clinical outcomes.
Methods: A total of 2963 (mean age, 81.4 years) patients participated in this subcohort study and were classified as having normal cognition (Mini-Mental State Examination (MMSE) score ≥24/30) or cognitive impairment (score ≤23/30) at baseline.
Background: Previous studies on mortality in atrial fibrillation (AF) included a limited number of elderly patients receiving direct oral anticoagulants (DOACs). This subanalysis of the ANAFIE Registry evaluated 2-year mortality according to causes of death of elderly non-valvular AF (NVAF) patients in the DOAC era.
Methods and results: The ANAFIE Registry was a multicenter prospective observational study.
Background: Data on the effectiveness and safety of oral anticoagulant (OAC) agents in very elderly nonvalvular atrial fibrillation patients with high bleeding risk are lacking.
Objectives: This study examined 2-year outcomes and effects of OAC agents among these patients using the ANAFIE (All Nippon Atrial Fibrillation in the Elderly) registry (N = 32,275) data.
Methods: Patients were classified into high-risk (age: ≥80 years; CHADS score: ≥2; and presence of ≥1 bleeding risk factor: creatinine clearance of 15-30 mL/minute, prior bleeding at critical sites, body weight of ≤45 kg, or continuous antiplatelet use) and reference groups.
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.
View Article and Find Full Text PDFBackground: Although heart rate (HR) is reportedly associated with major cardiovascular outcomes in the general population, its impact on adverse events in patients with non-valvular atrial fibrillation (NVAF) remains controversial. Thus, we performed analyses of data from the J-RHYTHM Registry to clarify this in patients with NVAF.
Results: Of 7406 outpatients with NVAF from 158 institutions, 6886 (age, 69.