Department School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine Position Endowed Associate Professor
|Article types||Original article|
|Peer review||Peer reviewed|
|Title||Current Status and Clinical Outcomes of Oral Anticoagulant Discontinuation After Ablation for Atrial Fibrillation in Japan - Findings From the AF Frontier Ablation Registry.|
|Journal||Formal name：Circulation journal : official journal of the Japanese Circulation Society|
|Domestic / Foregin||Domestic|
|Publisher||The Japanese Circulation Society|
|Volume, Issue, Page||pp.in press|
|Author and coauthor||Okumura Yasuo, Nagashima Koichi, Arai Masaru, Watanabe Ryuta, Yokoyama Katsuaki, Matsumoto Naoya, Otsuka Takayuki, Suzuki Shinya, Hirata Akio, Murakami Masato, Takami Mitsuru, Kimura Masaomi, Fukaya Hidehira, Nakahara Shiro, Kato Takeshi, Shimizu Wataru, Iwasaki Yu-Ki, Hayashi Hiroshi, Harada Tomoo, Nakajima Ikutaro, Okumura Ken, Koyama Junjiroh, Tokuda Michifumi, Yamane Teiichi, Momiyama Yukihiko, Tanimoto Kojiro, Soejima Kyoko, Nonoguchi Noriko, Ejima Koichiro, Hagiwara Nobuhisa, Harada Masahide, Sonoda Kazumasa, Inoue Masaru, Kumagai Koji, Hayashi Hidemori, Satomi Kazuhiro, Yazaki Yoshinao, Watari Yuji,|
|Summary||BACKGROUND:The safety of discontinuing oral anticoagulant (OAC) after ablation for atrial fibrillation (AF) in Japanese patients has not been clarified.
Methods and Results:A study based on the Atrial Fibrillation registry to Follow the long-teRm Outcomes and use of aNTIcoagulants aftER Ablation (AF Frontier Ablation Registry) was conducted. Data were collected from 3,451 consecutive patients (74.1% men; age, 63.3±10.3 years) who had undergone AF ablation at any of 24 cardiovascular centers in Japan between August 2011 and July 2017. During a 20.7-month follow-up period, OAC therapy was discontinued in 1,836 (53.2%) patients; 51 patients (1.5%) suffered a stroke/transient ischemic attack (TIA), 71 (2.1%) suffered major bleeding, and 36 (1.0%) died. Patients in whom OAC therapy was discontinued were significantly younger than those in whom OACs were continued, and their CHA2DS2-VASc scores were significantly lower. The incidences of stroke/TIA, major bleeding, and death were significantly lower among these patients. Upon multivariate adjustment, stroke events were independently associated with relatively high baseline CHA2DS2-VASc scores but not with OAC status.
CONCLUSIONS:Although the incidences of stroke/TIA, major bleeding, and death were relatively low among patients for whom OAC therapy was discontinued, stroke/TIA occurrence was strongly associated with a high baseline stroke risk rather than with OAC status. Thus, discontinuation of OAC therapy requires careful consideration, especially in patients with a high baseline stroke risk.