Publications by authors named "Atsushi Takita"
Background: Off-label under- and overdosing of direct oral anticoagulants (DOACs) in patients with atrial fibrillation (AF) is not uncommon in real-world practice.
Objective: This study aimed to identify efficacy and safety of off-label DOACs dose after AF ablation.
Methods: The RYOUMA registry was a prospective multicenter study of Japanese patients who underwent AF ablation between 2017 and 2018.
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
- The study analyzed data from 1057 lung cancer surgery patients in Japan to understand the relationship between surgery and venous thromboembolism (VTE).
- It found that the surgery alone (SA) group had a lower incidence of VTE (0.2%) compared to the surgery plus chemotherapy (SC) group (3.3%); however, the SA group had a higher risk for cerebral ischemia (1.3% vs 0.9%).
- The research suggested that higher D-dimer levels (above 1.2 μg/ml) were linked to lymph node metastasis and indicated a greater risk of VTE and advanced cancer in patients.
Article Synopsis
- The study evaluates the relationship between frailty and clinical outcomes in elderly Japanese patients with non-valvular atrial fibrillation (NVAF) undergoing catheter ablation (CA) to determine the impact of CA on frailty and assess outcomes based on frailty status.
- A total of 213 elderly patients (average age of 72.8 years) were analyzed, revealing that 12.8% were frail, 53.7% pre-frail, and 33.5% robust, with frail patients experiencing more cardiovascular and bleeding events; however, most did not have AF recurrence after 3 or 6 months post-CA.
- The findings suggest that CA can improve factors related to frailty, indicating that
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
Background: The D-dimer test is a simple test frequently used in routine clinical screening for venous thromboembolism (VTE). The Cancer-VTE Registry was a large-scale, multicenter, prospective, observational study in Japanese patients with cancer. This study aimed to clarify the relationship between D-dimer level at cancer diagnosis (baseline) and the incidence of events during cancer treatment (1-year follow-up period).
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- 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.
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- 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.
Background: This substudy of the Cancer-VTE Registry estimated venous thromboembolism (VTE) incidence and risk factors in pancreatic cancer patients.
Methods: The Cancer-VTE Registry was an observational study that collected VTE data from patients with solid tumors across Japan. We measured baseline VTE prevalence, and at 1-year follow-up, the cumulative incidence of symptomatic and composite VTE (symptomatic VTE and incidental VTE requiring treatment), bleeding, cerebral infarction/transient ischemic attack (TIA)/systemic embolic event (SEE), and all-cause death.
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.
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: This subgroup analysis of the Cancer-VTE Registry, a nationwide, large-scale, multicenter observational study with a 1-year follow-up, assessed real-world data on venous thromboembolism (VTE) among Japanese patients with breast cancer.
Methods: Patients with stage II-IV pretreatment breast cancer screened for VTE at enrollment were included. During the 1-year follow-up period, incidences of VTE, bleeding, and all-cause death, and background factors associated with VTE risk were examined.
Article Synopsis
- * The study analyzed data from 2,688 participants with ischemic stroke and various health conditions, using metrics like stroke incidence and bleeding events to measure effectiveness and safety.
- * Results showed that prasugrel had a slightly lower composite incidence of recurrent events (3.4%) compared to clopidogrel (4.3%), suggesting a potential benefit of prasugrel in preventing recurrent strokes.
Background: The Cancer-VTE Registry was a large-scale, multicenter, prospective registry designed to investigate real-world data on venous thromboembolism (VTE) incidence and risk factors in adult Japanese patients with solid tumors. This pre-specified subgroup analysis aimed to estimate the incidence of VTE, including VTE types other than symptomatic VTE, and identify risk factors of VTE in stomach cancer from the Cancer-VTE Registry.
Methods: Stage II-IV stomach cancer patients who planned to initiate cancer therapy and underwent VTE screening within 2 months before registration were enrolled.
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.